C-Reactive Protein

Many of you may have read reports in the popular press about a new cardiac marker called C-reactive protein (CRP). Two studies published in the New England Journal of Medicine earlier this month showed that lowering the levels of CRP in some patients can reduce their risk of getting heart attacks and of dying of heart disease. These effects seem to be additive to those gained by lowering LDL (the bad sort) of cholesterol.

CRP is a marker of inflammation in the body. It is made in a number of places in the body, including the liver and in the coronary arteries themselves when there is inflammation. It has been known for years that levels of CRP rise when people get heart attacks, and it is postulated that inflammation plays an important role in causing blockages of the coronary arteries.

So should you be tested for CRP, and should you do anything different if it is too high? Like many emerging medical areas, the answers are not entirely clear. The studies published this month only looked at people who already had significant coronary disease and were already on high doses of statins to reduce their cholesterol. It is not clear whether these results will apply to people who are at lower risk. It also must be noted that both teams of researchers who published these studies have received significant funding from drug companies that make drugs that can be used to lower CRP, and that one lead author actually makes money from each CRP test performed.

All that said, the data is suggestive that people with histories of heart disease ought to have their CRP measured and those with high levels, even if they have normal cholesterol numbers, ought to be treated with aggressive statin therapy. A trial is now underway to see if treating low risk patients with normal cholesterol values but high CRP will be of benefit. For the time being we recommend only those at higher risk of coronary disease consider checking and treating a high CRP. As always, if you have any questions, please give us a call or email.