Statins may be used to lower CRP levels

The question: Although used to lower cholesterol, statins also can reduce the levels of a protein in the blood known as CRP (C-reactive protein). Does lowering CRP levels also reduce the chances of having a heart attack?

This study: randomly assigned 3,745 people who had been hospitalized recently with a heart attack or chest pain to take daily doses of a statin – either Pravachol (pravastatin) or Lipitor (atorvastatin) – or a placebo. Participants were mostly men and averaged 58 years old. After about two years, there had been fewer repeat heart attacks or deaths among people with the lowest CRP levels than among those with higher levels, regardless of their cholesterol reading. CRP levels below 2 milligrams per liter correlated with a heart attack/death rate of 2.4 per 100 people when low-density lipoprotein (LDL) or “bad” cholesterol was below 70 milligrams per deciliter, and a rate of 3.2 per 100 people when LDL was 70 or higher. The heart attack/death rate per 100 people for CRP levels above 2 milligrams was 3.1 for lower LDL and 4.6 for higher LDL. CRP levels were unchanged for those who took the placebo.

Who may be affected by these findings? People with severe heart disease.

Caveats: The precise relationship between CRP and heart disease remains unclear. Study participants had severe heart disease; similar results may not occur in others. The study was funded in part by Bristol-Myers Squibb, which makes Pravachol. The lead author invented a patented blood test for CRP; he and five other authors have received fees from drug companies, including Pfizer, which makes Lipitor.

Bottom line: People who have had a heart attack or have recurring angina may want to ask a cardiologist about lowering their CRP level.

Find this study in the Jan. 6 issue of the New England Journal of Medicine; www.nejm.org.

Learn more about heart disease and risk factors at www.americanheart.org and www.mayoclinic.com.