Blog | Friday, October 5, 2012

QD: News Every Day--CRP, fibrinogen levels could help asses risk for cardiovascular events


Knowing the C-reactive protein (CRP) or fibrinogen levels in people at intermediate risk for a cardiovascular event could be used prevent cardiovascular disease events, a meta-analysis found.

Researchers analyzed data from 52 prospective studies that included nearly 247,000 participants without a history of cardiovascular disease, and reported results in the New England Journal of Medicine.

Knowing CRP and fibrinogen levels improved cardiovascular risk prediction in men but not in women (P less than or equal to 0.001 for the interaction). CRP also had greater predictive value in current smokers than in nonsmokers (P less than 0.001 for the interaction).

Researchers modeled targeted CRP assessment in people whose risk of a cardiovascular event was 10% to 20% for 10 years. Among 100,000 adults, 15,025 more people would be classified as falling in this risk range by knowing CRP levels. If ATP-III guidelines were followed, such as a risk of 20% or more, or having diabetes, another 690 people would be reclassified, and among this group, 151 would be expected to have a cardiovascular event within 10 years.

Researchers modeled targeted fibrinogen assessment in people whose risk of a cardiovascular event was 10% to 20% for 10 years. Of an additional 625 people who would be reclassified to a predicted risk of 20% or more, 134 would be expected to have a cardiovascular event within 10 years.

Assuming that people reclassified to a risk level of 20% or more would begin statin therapy, CRP assessment could prevent about 30 additional cardiovascular events over a period of 10 years and fibrinogen assessment could prevent about 27 events.

Researchers concluded, "Our results confirm that the relative usefulness of risk factors in prediction can vary considerably depending on whether the outcome chosen includes all cardiovascular events or coronary heart disease events only. Furthermore, risk scores proposed solely for the prediction of stroke may involve additional risk factors that are not considered here, such as atrial fibrillation."