Group items tagged

"Largest-ever meta-analysis finds CRP is unlikely to be causal for CVD December 21, 2009 | Lisa Nainggolan Cambridge, UK - In the largest and most comprehensive meta-analysis to date looking at C-reactive-protein (CRP) levels and risk of coronary heart disease (CHD) and stroke, British researchers conclude that CRP is unlikely to be a causal factor for cardiovascular disease [1]. Although CRP concentration was linearly associated with CHD, stroke, and vascular mortality, as well as nonvascular mortality, statistical adjustment for conventional cardiovascular risk factors "resulted in considerable weakening of associations," note the scientists of the Cambridge-based Emerging Risk Factors Collaboration (ERFC), who report their findings online December 21, 2009 in the Lancet. In an editorial accompanying the paper [2], Drs S Matthijs Boekholdt and John JP Kastelein (Academic Medical Center, Amsterdam, the Netherlands) say the UK authors "are to be commended for this impressive data set." Although the findings "add weight to the evidence of noncausality" for a role of CRP in the development of cardiovascular disease, "the debate can be resolved only by randomized trials with agents that specifically target CRP, and such compounds are currently under development," say the Dutch doctors. Commenting on the new meta-analysis for heartwire, Dr Paul Ridker (Brigham and Women's Hospital, Boston, MA), a long-time advocate of CRP and the lead investigator of the JUPITER trial, said: "Whether or not CRP is 'causal' for heart disease is neither the crucial issue at hand nor relevant for public health. What is crucial is getting international agreement that CRP identifies higher-risk individuals who would not otherwise qualify for a life-saving therapy, and then showing that such individuals clearly benefit from treatment. The new meta-analysis demonstrates the former, and JUPITER demonstrates the latter." "

VITAMIN D LOWERS C-REACTIVE PROTEIN (CRP) Van den Berghe and colleagues at the University of Leuven in Belgium appear to be the first to show that simple, natural and cheap vitamin D (cholecalciferol) lowers CRP in critically ill patients. Even small amounts of cholecalciferol (500 IU) lowered CRP by more than 25% in a small group of critically ill patients. Another marker of inflammation (IL-6) was reduced even more. The researchers also found that critically ill patients were profoundly deficient in vitamin D.

"New research shows a long-term benefit in screening people for CRP, a marker for inflammation, even if they have normal levels of bad cholesterol, because of increased long-term risk for heart attack, stroke and death. These findings, which will be published online today in the Journal of the American College of Cardiology (JACC), demonstrate that a very simple screening, age plus CRP, can identify individuals who may benefit from statin therapy. "This study builds on results from the landmark JUPITER trial, which showed that statins can prevent heart disease in people with normal LDL-c, or bad cholesterol, and an increased level of CRP," said Dr. Christie Ballantyne, director of the Center for Cardiovascular Disease Prevention at the Methodist DeBakey Heart & Vascular Center and last author on the study. "We have demonstrated that the cardiovascular disease event rates persist over time, validating that the risks identified in the JUPITER trial persist for nearly seven year"

Clinical Implications of JUPITER (Justification for the Use of statins in Prevention: an Intervention Trial Evaluating Rosuvastatin) in a U.S. Population Insights From the ARIC (Atherosclerosis Risk in Communities) Study Yang EY et al. J Am Coll Cardiol, 2009; 54:2388-2395, doi:10.1016/j.jacc.2009.10.006 Conclusions: ARIC participants with elevated hs-CRP and low LDL-C had a CVD event rate of 1.57% per year over 6.9 years, similar to the CVD event rate noted in the JUPITER study placebo group (1.36% per year over 1.9 years). The association of hs-CRP ≥2.0 mg/l with increased CVD risk and mortality regardless of LDL-C provides us a simple method of using age and hs-CRP level for identifying higher risk individuals. (Atherosclerosis Risk in Communities study; NCT00005131)

"March 29, 2009 | Michael O'Riordan Orlando, FL - Reducing LDL cholesterol and high-sensitivity C-reactive protein (hs-CRP) in primary-prevention patients treated with rosuvastatin (Crestor, AstraZeneca) results in better event-free survival than when neither of these targets are achieved or when LDL cholesterol alone is reduced, a new analysis shows [1]. Presenting the results of the Justification for the Use of Statins in Primary Prevention: An Intervention Trial Evaluating Rosuvastatin (JUPITER) study during an afternoon press conference at the American College of Cardiology 2009 Scientific Sessions, investigators say that initial interventions for low-risk primary-prevention patients remains lifestyle and dietary modifications, but for those choosing drug therapy, "reductions in both LDL cholesterol and hs-CRP are indicators of the success of treatment with statin therapy.""

What is C-reactive protein (CRP)? It is a blood-borne protein that originates in the liver and serves as an index of the body's inflammatory state. It is triggered by yet another inflammatory signal molecule, interleukin-6. What triggers this cascade of inflammatory markers? Any inflammatory stimulus, such as being overweight, lack of exercise, vitamin D deficiency, viral illness no matter how trivial, any inflammatory disease like arthritis, small LDL, high triglycerides, poor diet rich in processed foods, resistance to insulin, any injury, incipient diabetes, hidden cancer, lack of education (no kidding), etc.

C-reactive protein concentration and risk of coronary heart disease, stroke, and mortality: an individual participant meta-analysis. The Lancet, Early Online Publication, 22 December 2009 doi:10.1016/S0140-6736(09)61717-7 Interpretation CRP concentration has continuous associations with the risk of coronary heart disease, ischaemic stroke, vascular mortality, and death from several cancers and lung disease that are each of broadly similar size. The relevance of CRP to such a range of disorders is unclear. Associations with ischaemic vascular disease depend considerably on conventional risk factors and other markers of inflammation.

CHART: Statins Reduce Risks: A study of 18,000 people with high levels of C-reactive protein, or CRP, found that the risk of a heart attack or stroke was cut in half among those who took a statin. The study was stopped after two years, but some participants were tracked for up to five years. (Sources: Dr. Paul M. Ridker; New England Journal of Medicine) (pg.A21) A large new study suggests that millions more people could benefit from taking the cholesterol-lowering drugs known as statins, even if they have low cholesterol, because the drugs can significantly lower their risk of heart attacks, strokes and death. The study, involving nearly 18,000 people worldwide, tested statin treatment in men 50 and older and in women 60 and older who did not have high cholesterol or histories of heart disease. What they did have was high levels of a protein called high-sensitivity C-reactive protein, or CRP, which indicates inflammation in the body.

Chemopreventive and renal protective effects for docosahexaenoic acid (DHA): implications of CRP and lipid peroxides. Elmesery ME, Algayyar MM, Salem HA, Darweish MM, El-Mowafy AM. Cell Div. 2009 Apr 2;4(1):6. [Epub ahead of print] PMID: 19341447 doi:10.1186/1747-1028-4-6

Last week, Harvard researchers reported how healthy 50-year-old men and 60-year-old women could benefit from taking a statin even if they didn't have high cholesterol. The people they studied had high levels of C-reactive protein, or CRP, which is a marker for inflammation. The study showed that risk for major heart problems was cut by about 50 percent among the statin users.\n\nBut like many industry-sponsored drug studies, the results focused on something called "relative risk," which compares differences between study groups. Relative risk has the effect of exaggerating a drug's benefits. What does a 50 percent reduction in heart risk mean? It means that just one out of 120 statin users was helped by the drug.

Eggs modulate the inflammatory response to carbohydrate restricted diets in overweight men. Ratliff JC, Mutungi G, Puglisi MJ, Volek JS, Fernandez ML. Nutr Metab (Lond). 2008 Feb 20;5:6. PMID: 18289377 Carbohydrate restricted diets (CRD) consistently lower glucose and insulin levels and improve atherogenic dyslipidemia [decreasing triglycerides and increasing HDL cholesterol (HDL-C)]. We have previously shown that male subjects following a CRD experienced significant increases in HDL-C only if they were consuming a higher intake of cholesterol provided by eggs compared to those individuals who were taking lower concentrations of dietary cholesterol. Here, as a follow up of our previous study, we examined the effects of eggs (a source of both dietary cholesterol and lutein) on adiponectin, a marker of insulin sensitivity, and on inflammatory markers in the context of a CRD. Conclusion A CRD with daily intake of eggs decreased plasma CRP and increased plasma adiponectin compared to a CRD without eggs. These findings indicate that eggs make a significant contribution to the anti-inflammatory effects of CRD, possibly due to the presence of cholesterol, which increases HDL-C and to the antioxidant lutein which modulates certain inflammatory responses.

"November 25, 2009 | Michael O'Riordan Orlando, FL - Treating healthy women with low LDL cholesterol but elevated high-sensitivity C-reactive protein (hsCRP) levels with rosuvastatin (Crestor, AstraZeneca) cuts their risk of cardiovascular events in half, according to a new analysis of Justification for the Use of Statins in Primary Prevention: An Intervention Trial Evaluating Rosuvastatin (JUPITER). The reduction in risk is consistent with the reduction observed in the overall trial, and with the 42% benefit observed in men.

Serum 25-hydroxyvitamin D3 concentrations and carotid artery intima-media thickness among type 2 diabetic patients. Targher G, Bertolini L, Padovani R, Zenari L, Scala L, Cigolini M, Arcaro G. Clin Endocrinol (Oxf). 2006 Nov;65(5):593-7. PMID: 17054459 CONCLUSIONS: Hypovitaminosis D is highly prevalent in type 2 diabetic adults and is strongly and independently associated with increased carotid IMT. Further investigation into whether vitamin D may play a role in the prevention of atherosclerosis appears to be warranted.

An inverse relationship between plasma n-3 fatty acids and C-reactive protein in healthy individuals M A Micallef, I A Munro and M L Garg Eur J Clin Nutr 63: 1154-1156; advance online publication, April 8, 2009; doi:10.1038/ejcn.2009.20

Conclusions In this trial of apparently healthy persons without hyperlipidemia but with elevated high-sensitivity C-reactive protein levels, rosuvastatin significantly reduced the incidence of major cardiovascular events. \n\nRosuvastatin to prevent vascular events in men and women with elevated C-reactive protein.\nRidker PM, Danielson E, Fonseca FA, Genest J, Gotto AM Jr, Kastelein JJ, Koenig W, Libby P, Lorenzatti AJ, MacFadyen JG, Nordestgaard BG, Shepherd J, Willerson JT, Glynn RJ; JUPITER Study Group.\nN Engl J Med. 2008 Nov 20;359(21):2195-207. Epub 2008 Nov 9.\nPMID: 18997196

Expanding the orbit of primary prevention--moving beyond JUPITER. Hlatky MA. N Engl J Med. 2008 Nov 20;359(21):2280-2. Epub 2008 Nov 9. PMID: 18997195

Dietary cod protein reduces plasma C-reactive protein in insulin-resistant men and women. Ouellet V, Weisnagel SJ, Marois J, Bergeron J, Julien P, Gougeon R, Tchernof A, Holub BJ, Jacques H. J Nutr. 2008 Dec;138(12):2386-91. PMID: 19022962 Therefore, these results show that CP can lower hsCRP, a marker of inflammation associated with insulin resistance and type 2 diabetes.

Libby P. Inflammation and cardiovascular disease mechanisms. Am J Clin Nutr. 2006 Feb;83(2):456S-460S. Review. PMID: 16470012 [PubMed - indexed for MEDLINE]

Jenkins DJ, Kendall CW, Marchie A, Faulkner DA, Wong JM, de Souza R, Emam A, Parker TL, Vidgen E, Lapsley KG, Trautwein EA, Josse RG, Leiter LA, Connelly PW. Effects of a dietary portfolio of cholesterol-lowering foods vs lovastatin on serum lipids and