Originally published December 11 2009
C-Reactive Protein Screening Found Virtually Useless
by David Gutierrez, staff writer
(NaturalNews) Two studies published in the Journal of the American Medical Association have added to the evidence that the C-reactive protein test provides little benefit to doctors seeking to assess their patients' risk of cardiovascular disease.
"The evidence does not support routine screening of people for these biomarkers,'' said lead researcher Thomas Wang of the Massachusetts General Hospital Heart Center.
Many researchers have long believed that high levels C-reactive protein, a marker of inflammation, are significantly correlated with a higher risk of cardiovascular disease. Many doctors have advocated general screenings for the protein, saying that high levels could indicate a propensity toward the disease even in people without traditional symptoms such as high cholesterol, high blood pressure, chest pain or a history of smoking. Since half of all heart attacks or strokes involve cases with no prior symptoms, such a screening could be a powerful, life-saving tool. However, many doctors have remained skeptical of the test, and its use still varies widely from doctor to doctor.
Cardiovascular disease kills 900,000 people every year in the United States, and more than 17 million worldwide. It is the world's number one cause of death, accounting for a full 30 percent of all fatalities.
The C-reactive protein test was developed by doctors at Brigham and Women's Hospital, and they benefit financially each time the test is used. Researchers at that school recently published a study showing that when people with high C-reactive protein levels but healthy cholesterol levels were prescribed statin drugs (designed to lower cholesterol), their risk of heart attacks and strokes was decreased by 50 percent.
One of the new studies casts serious doubt on these findings. Wang and colleagues, along with researchers from Lund University in Sweden, reviewed the medical records of more than 5,000 people who had resided in Sweden between 1991 and 2006. Participants were all tested for six suspected markers of cardiovascular disease, including C-reactive protein.
Using a statistical analysis, the researchers calculated what effect knowing a patient's level of C-reactive protein or the other markers would have had on a doctor's ability to predict heart attack or stroke risk. They found that while 8 percent of patients would have been placed into a different risk category based on the biomarker tests, only 1 percent of patients would have needed to receive different treatment.
"What we found is that, in fact, even after measuring those additional biomarkers that there wasn't a great deal of benefit in terms of understanding who was more likely to develop heart disease," Wang said. "For the majority of patients, having the information of the biomarker probably wouldn't make a difference."
In a second study published in the same journal, London researchers found through a genetic analysis of more than 100,000 people that, contrary to the view held by many researchers, C-reactive protein does not play any direct role in increasing a person's risk of cardiovascular disease. This study did not rule out the possibility that the protein may still function as a marker of disease risk.
"There certainly has been a very vocal constituency in the idea that [C-reactive protein] causes or contributes to the development of heart disease," said Daniel Rader of the University of Pennsylvania.
A number of pharmaceutical companies are already at work developing drugs to directly lower levels of the protein. The new findings may cut support for this research.
"It is likely that drugs or agents that specifically target CRP are not going to work," said Michael S. Lauer of the National Heart, Lung and Blood Institute.
The new tests are not the first to cast doubt on the usefulness of C-reactive protein screening. A 2004 study concluded that the test was only of moderate value in predicting heart disease risk.
Sources for this story include: www.boston.com; www.voanews.com.
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