the evolution of evidence. In a large study, the C-reactive protein didn
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A new study may be the last word in a controversy that plagued the search heart disease for years: if a marker of inflammation called C-reactive protein (CRP) causes heart attacks and strokes. In a survey of more than 128,000 people, researchers found that genes that raise CRP levels are not more likely cardiovascular disease. Although the study reaches the same conclusion as the previous work, its massive size, it is statistically the most powerful of this issue and difficult to refute test, experts say.
Produced by the liver, CRP has long been eyed as a suspect in heart disease. In part, this is because observational studies, which regularly found that higher CRP levels are associated with later heart problems. CRP is a vague indicator of many health problems Hike the risk of heart attacks and strokes, including obesity and type 2 diabetes, but these kinds of associations do not mean that CRP is actually causing heart attack. Indeed, last fall, Danish researchers reported that genes that raise CRP do not appear to cause cardiovascular disease ( Science NOW, October 29, 08).
Now, a team of three dozen researchers from the UK, Canada, Germany, and elsewhere have joined forces to reconsider the question. They shot many health studies that have banked the DNA of tens of thousands of participants. As the Danish group earlier one, led by epidemiologist Paul Elliott of Imperial College London, started with a simple premise: If high levels of CRP causes heart attacks, and the genes that increase CRP levels should also increase the risk of heart attacks. The researchers studied three variants each raised CRP by about 20%. They then tested whether having at least one of these variants was most likely a cardiovascular disease in more than 28,000 people with the disease and 100,000 people without. The result: The genes had no effect on heart disease, the group reports tomorrow The Journal of the American Medical Association
"It's pretty much nailed shut" now, says James de Lemos. , A cardiologist at the University of Texas Southwestern Medical Center in Dallas. "It's hard for me to imagine CRP is causal" Instead, he and others believe, the protein may be linked to other molecules that stimulate the disease. - Or it may simply indicate inflammation of the arteries which is already present, not the disease that is yet to come
given the news. data Mark Pepys, an expert in CRP at University College London, says he has no meaning to find a drug that targets CRP to prevent heart attacks. whether CRP is a useful way to assess the risk of disease later is in the air, he said, because it is unclear whether the levels of CRP add useful information beyond the usual measures, such as family history and obesity.
the latter CRP study also raises questions about a trial last year called JUPITER published. in this study, people with normal cholesterol levels were given a drug that lowers cholesterol and CRP, and their hearts have benefited ( Science NOW, November 10, 08). Some argued that the trial prevented the disease because CRP levels dropped, but others said the real advantage is due to lowering cholesterol in those whose levels are normal to start. Increasingly, the latter seems to be the case, said Elliott.
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