A new study, conducted to find people at higher risk of developing heart attack and stroke, has come to the conclusion that presence of calcium in the coronary arteries is a much better predictor of these conditions as compared to C- reactive protein in patients with a normal level of LDL. The study, published in the August 19, 2011 issue of “The Lancet”, was conducted on more than 2,000 people led by Michael J. Blaha, M.D. M.P.H, a cardiology fellow at the Johns Hopkins University School of Medicine and the Johns Hopkins Heart and Vascular Institute. The results of the study will have implications on deciding the patients who would benefit by cholesterol-lowering statin medication, in case their LDL levels are normal.
2083 people from the ongoing Multi-Ethnic Study on Atherosclerosis, known as MESA, which is an NIH-funded Hopkins-affiliated study, were selected for this study and were followed up for six years. The researchers compared the risk of developing heart attack and stroke in patients with a normal LDL of less than 130 mg/dL - among those who had calcium in their coronary arteries as detected by CT scan or those who had a high level of C- reactive protein in the blood. They found that measurable amounts of calcium were present in the coronary arteries of 95% people who had heart attacks, strokes or heart-related deaths. Almost 13.4% patients who had the highest levels of coronary calcium (with scores greater than 100 on a calcium scoring test) had a heart attack or stroke during the study. Only 2% patients with a similar fate had high C- reactive protein in their blood.
The researchers concluded that C- reactive protein has a little predictive value for heart attack and stroke after accounting for risk factors like age, gender, ethnicity, hypertension, obesity, diabetes, smoking and a family history of heart disease. They also deduced that only patients with presence of calcium in the coronary arteries require to be treated with statin medication.
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