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| |  C-Reactive Protein Levels Correlate With Future Risk of MI, Stroke, and Cancers NEW YORK -- December 21, 2009 -- There has been intense interest among researchers during the past decade about whether blood concentrations of C-reactive protein (CRP) is a causal factor in heart disease. Earlier studies had suggested that this protein might be as important in the causation of heart attack as are blood cholesterol levels. In a comprehensive study on the associations of blood levels of CRP with major diseases, published online in The Lancet, John Danesh, University of Cambridge, Cambridge, United Kingdom, and colleagues from the Emerging Risk Factors Collaboration (ERFC) combined information from 54 long-term medical surveys comprising over 160,000 people in 18 countries. The researchers show that CRP concentration is associated with future risk of a wide range of common diseases, including myocardial infarction (MI), stroke, deaths from various cancers, chronic lung disease, injuries, and other conditions. Most of the associations between CRP levels and heart disease were explained, however, by risk factors already known to cause heart disease such as smoking, blood pressure, obesity, and cholesterol levels. This finding reduces the likelihood that CRP is a cause of heart disease. “Although our results support the idea that some process related to persistent inflammation is associated with vascular disease and other chronic disorders, most of the association with ischaemic vascular disease depends on conventional risk factors and fibrinogen concentration.” The authors concluded that further large studies are needed to assess other markers of inflammation, as well as their genetic and lifestyle determinants. “Further work is also needed to assess whether evidence of low-grade inflammation mainly indicates external triggers (eg, socioeconomic position or infection), insulin resistance, hereditary predisposition, or some combination of such factors,” they wrote. In an accompanying comment, S. Matthijs Boekholdt, MD, and John J.P. Kastelein, MD, Academic Medical Center, Amsterdam, the Netherlands, said: “One of the prominent topics in this debate is CRP’s role in guiding decision-making for the primary prevention of cardiovascular disease. Current guidelines advise the use of established risk factors to quantify an individual’s cardiovascular risk. These guidelines recommend that people at high risk should be treated, whereas for people at intermediate risk additional information should be obtained to guide decision-making. CRP measurement might be valuable in the fine-tuning of the choice of treatment in this specific subgroup... The wealth of data collected by ERFC will be an excellent source for future analyses to more accurately define the role of CRP in clinical decision-making.”
SOURCE: The Lancet
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