Test may be better gauge of heart attack risk
October 10th, 2011
02:00 PM ET

Test may be better gauge of heart attack risk

A growing number of patients should consider blood tests that go beyond the standard cholesterol numbers to gauge their risk for heart disease, an expert panel says.

Patients considered at intermediate risk for heart disease, perhaps the majority of the population, should be tested for C-reactive protein, a panel of specialists concluded in the current Journal of Clinical Lipidology.

Total cholesterol, LDL and HDL do not do as well predicting heart attack and stroke risk in patients with diabetes or metabolic syndrome, especially if those patients are already taking a cholesterol-lowering statin medication, said Dr. Michael H. Davidson, who headed the 17-member panel.

“We wanted to give guidance. This is a common problem,” added Davidson, director of Preventive Cardiology at the University of Chicago Pritzker School of Medicine.

The problem is becoming more common as the prevalence of obesity, diabetes and metabolic syndrome increases. Metabolic syndrome is a combination of symptoms that can include abdominal obesity, low HDL (good cholesterol), high blood pressure, insulin resistance and inflammation.

“When a person walks into the office stomach first, that’s intermediate risk,” Davidson said. “Intermediate risk is the bulk of the population and we’re not sure what to do in many of those patients.”

Family history, lifestyle choices such as diet and exercise and whether a patient smokes also may be factors whether someone is considered intermediate risk.

Standard measures miss about 30% of patients who will develop cardiovascular disease, Davidson added.

The C-reactive protein (CRP) level is considered a marker for inflammation. CRP is associated with plaques in the blood vessels.  Plaque can narrow the blood vessels in coronary arteries and cause chest pain. They can also rupture and cause heart attacks and strokes.

The Women’s Health Study found C-reactive protein was better at predicting coronary events like heart attack than LDL, the bad cholesterol; HDL, the good cholesterol; total cholesterol; or a ratio between total and good cholesterol.

Another large-scale trial showed high C-reactive protein levels were able to identify risk of future heart disease in patients who had low LDL.

“Because traditional risk scoring and routine cholesterol screenings miss a significant percentage of patients at risk for events, consideration might be given to routine inclusion of CRP,” the task force wrote in the article.

In additional to coming out in favor of CRP, the expert panel said it would be “reasonable for many [intermediate risk] patients” to have a blood test measuring the number of LDL particles - in addition to the standard LDL cholesterol level.

LDL particles carry cholesterol to the blood vessels, but the amount of cholesterol each particle carries varies. A higher LDL particle number is associated with more plaque buildup.

Patients with a high LDL particle number are candidates for cholesterol-lowering statin drugs even if their standard LDL number is normal, the panel concluded.

The advice of the panel of lipidologists goes beyond what the American Heart Association recommends.

An American College of Cardiology Foundation/American Heart Association task force did not recommend any tests other than the traditional cholesterol in patients under 50 who did not have symptoms.

But this task force said CRP tests were “reasonable” in men over 50 and women over 60 and “may be considered” in younger men and women who were at intermediate risk.

Davidson said the panel’s opinions on assessing the risk of heart disease were the result of six months of work, but they do not constitute official guidelines. He added that the panel’s conclusions were based on the best evidence available, and he hopes they will prompt more research looking at how well these tests predict outcomes.

soundoff (132 Responses)
  1. Kuikseelt

    canada pfizer viagra buy viagra in los angeles ordering viagra onl

    February 10, 2021 at 09:50 | Report abuse | Reply
  2. KvaxMile

    payday loans minden nv payday loan in san fernando valley ace cash payday loan review

    February 12, 2021 at 22:48 | Report abuse | Reply
  3. AhbzEncox

    $2600 payday loan payday loan shops crawley extra cash loan ocbc

    February 13, 2021 at 05:50 | Report abuse | Reply
  4. JbbnEncox

    cialis swiss free 30 day trial of cialis can you take cialis into thailand

    February 13, 2021 at 15:40 | Report abuse | Reply
  5. LabxEncox

    is there counterfeit cialis is it safe to take cialis daily comprar cialis soft tabs

    February 13, 2021 at 20:38 | Report abuse | Reply
  6. FbsgZisse

    dapoxetine cialis herbal form of cialis cialis cheapest prices

    February 14, 2021 at 00:33 | Report abuse | Reply
  7. AbcfTeneseelt

    status of female viagra buy viagra on line? buy viagra online

    February 14, 2021 at 05:50 | Report abuse | Reply
  8. JbnvCrulk

    money tree payday loans surrey cash loans registration quick cash loan with bad credit

    February 15, 2021 at 18:23 | Report abuse | Reply
  9. FqbbEncox

    pocket payday 12 month loans cash advance on my walmart card money train payday loans

    February 16, 2021 at 02:55 | Report abuse | Reply
  10. NbnhZisse

    ordering sildenafil online without prescription viagara lowest cost for viagra

    February 16, 2021 at 07:31 | Report abuse | Reply
  11. plaquenil drug

    how to erectile dysfunction what does plaquenil treat erectile vitamins

    February 16, 2021 at 08:07 | Report abuse | Reply
  12. frolep rotrem

    I want to show my thanks to you for bailing me out of such a condition. As a result of researching throughout the search engines and finding strategies which were not beneficial, I believed my life was well over. Existing minus the answers to the difficulties you have solved by means of the short post is a serious case, as well as those that would have negatively damaged my entire career if I hadn't encountered your blog post. Your actual training and kindness in playing with every aspect was valuable. I don't know what I would've done if I hadn't come across such a solution like this. I'm able to at this time look forward to my future. Thank you very much for your specialized and effective guide. I won't be reluctant to endorse your web page to anyone who requires support about this topic.


    February 18, 2021 at 01:44 | Report abuse | Reply
  13. pc repair

    I've been browsing online greater than 3 hours as of late, but I by no means discovered any fascinating article like yours. It?¦s beautiful price sufficient for me. In my view, if all site owners and bloggers made just right content as you did, the net might be much more helpful than ever before.


    February 21, 2021 at 05:29 | Report abuse | Reply
  14. buy tadalafil

    erectafil 20 tadalafil generic steel drops medicine

    February 24, 2021 at 09:53 | Report abuse | Reply
  15. canadian viagra

    https://genericviagragog.com herbal viagra

    February 27, 2021 at 08:46 | Report abuse | Reply
  16. KndnMile

    viagra natural herbal viagra viagra essential oil

    February 28, 2021 at 06:31 | Report abuse | Reply
  17. FjjuZisse

    penis on viagra visual viagra viagra prescription online

    March 1, 2021 at 06:38 | Report abuse | Reply
  18. NbmoZisse

    pictures of penis on cialis generic cialis mastercard buy cialis

    March 2, 2021 at 21:19 | Report abuse | Reply
  19. Myles Bunson

    Hey there just wanted to give you a quick heads up. The words in your article seem to be running off the screen in Opera. I'm not sure if this is a format issue or something to do with web browser compatibility but I thought I'd post to let you know. The style and design look great though! Hope you get the problem resolved soon. Cheers


    March 3, 2021 at 00:06 | Report abuse | Reply
  20. escorts in Uttarahalli

    Thanks, this is a great list. I’m now following around half the folks I’ve commented on – so for me this has been a double win – the comment and the further reading material that helps me and my blog!


    March 24, 2021 at 12:19 | Report abuse | Reply
  21. AbgcEncox

    https://thesiswritingtob.com/ – thesis writing doctoral thesis defense editing thesis thesis for phd

    March 24, 2021 at 13:28 | Report abuse | Reply
  22. Elva Tolley

    I like what you guys are up too. Such clever work and reporting! Keep up the superb works guys I have incorporated you guys to my blogroll. I think it will improve the value of my site 🙂


    March 24, 2021 at 17:57 | Report abuse | Reply
  23. Ardelia Lym

    Hi there! I know this is kind of off topic but I was wondering if you knew where I could find a captcha plugin for my comment form? I'm using the same blog platform as yours and I'm having difficulty finding one? Thanks a lot!


    March 25, 2021 at 00:14 | Report abuse | Reply
  24. JvqqEncox

    https://dissertationahelp.com/ – dissertations express best dissertation dissertation writing help uk best dissertation writing service

    March 25, 2021 at 05:00 | Report abuse | Reply
  25. Russ Kuffel

    Hello my loved one! I wish to say that this post is amazing, great written and include almost all vital infos. I would like to see extra posts like this .


    March 25, 2021 at 10:03 | Report abuse | Reply
  26. LmoppEncox

    http://essaywriteris.com/ – write my essay students buy essay online for cheap buy an essay online cheap best essay writers online

    March 25, 2021 at 12:47 | Report abuse | Reply
  27. BrfgMile

    [url=https://ljcialishe.com/]how to get cialis for free[/url] [url=https://cialisvja.com/]cialis daily[/url] [url=https://viagraonlinejc.com/]does viagra work on women[/url] [url=https://viagratx.com/]walmart viagra[/url] [url=https://buycialisxz.com/]cialis 10 mg[/url]

    March 26, 2021 at 09:35 | Report abuse | Reply
  28. AbgcEncox

    https://thesiswritingtob.com/ – business thesis topics thesis statistics help what is thesis in writing thesis proposal writing service

    March 27, 2021 at 08:20 | Report abuse | Reply
  29. GrvCrulk

    https://kloviagrli.com/ – viagra how it works https://vigedon.com/ – how to make natural viagra https://llecialisjaw.com/ – cialis 5 mg https://jwcialislrt.com/ – cost of cialis in canada https://jecialisbn.com/ – buy cialis cheap

    March 30, 2021 at 04:42 | Report abuse | Reply
  30. AbgcEncox

    https://thesiswritingtob.com/ – phd thesis paper thesis online writing with a thesis help with thesis

    April 1, 2021 at 13:32 | Report abuse | Reply
  31. FbshEncox

    https://thesisacloud.com/ – thesis abstracts thesis literature review thesis writing service thesis statistics

    April 3, 2021 at 13:41 | Report abuse | Reply
  32. AbgcEncox

    [url=https://thesiswritingtob.com/]thesiswritingtob.com[/url] thesis guidelines thesiswritingtob.com thesis services

    April 9, 2021 at 06:37 | Report abuse | Reply
1 2 3

Post a comment


CNN welcomes a lively and courteous discussion as long as you follow the Rules of Conduct set forth in our Terms of Service. Comments are not pre-screened before they post. You agree that anything you post may be used, along with your name and profile picture, in accordance with our Privacy Policy and the license you have granted pursuant to our Terms of Service.

About this blog

Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.