The Case for C-Reactive Protein as a Risk Marker for Coronary Heart Disease
Authors: Nancy R. Cook
Journal: Annals of Internal Medicine (2010)

Letters16 March 2010The Case for C-Reactive Protein as a Risk Marker for Coronary Heart DiseaseNancy R. Cook, ScDNancy R. Cook, ScDFrom Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-152-6-201003160-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Buckley and colleagues (1) state that the utility of measuring C-reactive protein (CRP) is uncertain and conclude that routine screening by CRP levels cannot be recommended. The reasoning behind this conclusion, however, seems flawed. First, since the literature review in 2007, additional articles have been published, particularly ones featuring risk reclassification (including the Reynolds Risk Score for men [2] and the analysis of high-sensitivity CRP in the Framingham cohort [3]). The latter work should replace the cited negative study from Framingham, which did not use the high-sensitivity assay.Second, the authors cite a lack of evidence that ...References1. Buckley DI, Fu R, Freeman M, Rogers K, Helfand M. C-reactive protein as a risk factor for coronary heart disease: a systematic review and meta-analyses for the U.S. Preventive Services Task Force. Ann Intern Med. 2009;151:483-95. [PMID: 19805771] LinkGoogle Scholar2. Ridker PM, Paynter NP, Rifai N, Gaziano JM, Cook NR. C-reactive protein and parental history improve global cardiovascular risk prediction: the Reynolds Risk Score for men. Circulation. 2008;118:2243-51, 4p following 2251. [PMID: 18997194] CrossrefMedlineGoogle Scholar3. Wilson PW, Pencina M, Jacques P, Selhub J, D'Agostino R, O'Donnell CJ. C-reactive protein and reclassification of cardiovascular risk in the Framingham Heart Study. Circ Cardiovasc Qual Outcomes. 2008;1:92-7. [PMID: 20031795] CrossrefMedlineGoogle Scholar4. Pfeffer MA, Sacks FM. Leapfrogging data: no shortcuts for safety or efficacy information [Editorial]. Circulation. 2008;118:2491-4. [PMID: 19064690] CrossrefMedlineGoogle Scholar5. Hlatky MA, Greenland P, Arnett DK, Ballantyne CM, Criqui MH, Elkind MS, et al; American Heart Association Expert Panel on Subclinical Atherosclerotic Diseases. Emerging Risk Factors and the Stroke Council. Criteria for evaluation of novel markers of cardiovascular risk: a scientific statement from the American Heart Association. Circulation. 2009;119:2408-16. [PMID: 19364974] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoC-Reactive Protein as a Risk Factor for Coronary Heart Disease: A Systematic Review and Meta-analyses for the U.S. Preventive Services Task Force David I. Buckley , Rongwei Fu , Michele Freeman , Kevin Rogers , and Mark Helfand The Case for C-Reactive Protein as a Risk Marker for Coronary Heart Disease David I. Buckley and Mark Helfand Metrics Cited ByCorrelation of high-sensitivity C-reactive protein and carotid plaques with coronary artery disease in elderly patients 16 March 2010Volume 152, Issue 6Page: 406KeywordsC-reactive proteinsConflicts of interestCoronary heart diseaseHeartMedical risk factorsProspective studiesReasoningStatins ePublished: 16 March 2010 Issue Published: 16 March 2010 CopyrightCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...