NEW STUDY BY LDS HOSPITAL HEART RESEARCHERS FINDS CHOLESTEROL LEVELS NOT BEST PREDICTOR OF SURVIVAL FROM HEART DISEASE; INFLAMMATION MARKERS ARE KEY TO PREDICTING VASCULAR RISK
SALT LAKE CITY -- Most people know that having high cholesterol puts them at risk of developing coronary artery disease. Now a major new study by cardiac researchers at Intermountain Health Care's LDS Hospital reveals that levels of a marker of inflammation called C-reactive protein actually do a better job of predicting who will benefit from medication and who will die among patients who already have the disease.
The study is published in the November 2000 issue of the Journal of the American College of Cardiology.
"The more C-reactive protein you have, the higher your risk of dying," explained co-author J. Brent Muhlestein, MD, director of cardiac research at LDS Hospital. "But the more C-reactive protein you have, the more benefit you get from cholesterol-lowering drugs called statins."
In the study, Dr. Muhlestein and his colleagues at LDS Hospital took blood samples from 985 patients with severe coronary artery disease and tested their levels of cholesterol and C-reactive protein. The researchers then tracked the patients for an average of three years to see which patients died. By the time the researchers were ready to analyze their data, 109 patients had died.
By examining these patients' records, the researchers found that baseline cholesterol levels didn't predict which patients would die. However, C-reactive protein levels did. And although prescribing statins boosted survival rates for all patients regardless of their cholesterol levels, the drugs seemed to be of most benefit to those with the highest levels of C-reactive protein.
Although the study's results need to be confirmed by a randomized trial, Dr. Muhlestein is already putting the findings into practice at LDS Hospital, where patients are already benefiting from statin therapy.
"It's very hard to justify withholding statin therapy from patients with coronary artery disease just because they don't have high cholesterol," he said. "At LDS Hospital, we've concluded that the results justify giving every patient with coronary artery disease at least a starting dose of a statin regardless of their cholesterol levels."
Paul M. Ridker, MD, of Brigham and Women's Hospital in Boston praised the study. "These data confirm prior reports that statin therapy lowers C-reactive protein levels and demonstrate that C-reactive protein levels predict vascular risk," he said. "The study is exciting because it corroborates our previous work suggesting that this may represent one of the mechanisms by which statin therapy actually works."
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