November 18, 2002 CHICAGO (AP) -- If inflammation triggers heart attacks, does lowering it save lives?
New evidence, including a major study published last week, suggests that painless inflammation in the bloodstream is an even more potent cause of heart attacks than cholesterol is. However, some doctors are reluctant to test for inflammation because there is no clear evidence that lowering it improves health.
On Sunday, doctors announced the start of a major study intended to settle the question. About 15,000 people will be enrolled in an experiment to see if a statin drug can prevent heart attacks and strokes by reducing inflammation.
The statins are already a mainstay of heart care because they lower LDL, the bad cholesterol. However, doctors know they can also lower levels of C-reactive protein, or CRP, by 15 percent to 25 percent.
CRP is one of the body's inflammatory proteins, produced to fight infections and promote healing. Many believe that chronic exposure to high levels of CRP triggers heart attacks by making fatty buildups in the arteries more likely to burst.
Dr. Paul Ridker of Boston's Brigham and Women's Hospital announced the upcoming study Sunday at the annual meeting the American Heart Association. Ridker pioneered research in the field, including a study last week showing that those with high CRP levels are twice as likely as those with high cholesterol to die from heart attacks and strokes.
Ridker's new study will be financed by AstraZeneca and use its statin, rosuvastatin, which is not yet approved for routine prescription in the United States. It will involve men and women with no history of heart trouble, LDL in the safe range below 130 and CRP above two milligrams per deciliter of blood.
The average CRP reading in the United States is 1.5. Ridker's studies show the risk is dramatically higher when levels hit three.
Exercising and losing weight can also lower CRP levels. Dr. Sidney Smith, the heart association's research director, said measuring CRP may help doctors convince patients to live healthier, but they should not assume statins will help until Ridker's study is finished.
"I find it hard to advocate putting tens of millions of patients on statins without knowing what the outcome will be," Smith said.
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