Despite the current range of risk factors taken into consideration by GPs one third of heart attacks occur in patients who exhibit low or no risk factors.
However, recent studies in the US have clearly demonstrated that the measurement of indicators of inflammation can predict the risk of cardiovascular disease and the outcome of cardiovascular and peripheral vascular events – survival after a heart attack or stroke.
In the last three years Dr Paul Ridker, cardiologist and researcher at Brigham and Women’s hospital in Boston USA has reported two major studies in which levels of C – reactive protein (CRP) were elevated above the normal baseline, among apparently healthy individuals who subsequently had a first heart attack.
These and other studies have confirmed that CRP can function as both a primary and a secondary marker for cardiovascular disease, better at identifying those at risk and those who will have the poorest outcome after their first attack
Therefore it has been proposed that CRP is used as a global indicator of risk, alongside other underlying risk factors such as age, hormones, diabetes, smoking obesity and hypertension.
The routine testing of CRP levels only became possible with the development of highly sensitive assays capable of accurately measuring levels around 1-5 mg/L. Such an assay is Dade Behring’s High Sensitivity CRP assay which has been used in a number of studies. It has also been adopted at Dr Ridker’s hospital as part a patented ‘Risk profile for artherosclerotic disease’.
This new diagnostic technique could help in determining if the prescribing of cholesterol lowering drugs or aspirin is advisable. These studies and their findings may also have opened up an even greater opportunity for new therapies to prevent and treat heart disease. It can be argued that the CRP assay should become as routine as measuring a patient’s serum cholesterol level if we are to close the gap that exists in early warning system for coronary heart disease. |