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

Letters16 March 2010The Case for C-Reactive Protein as a Risk Marker for Coronary Heart DiseaseDavid I. Buckley, MD, MPH and Mark Helfand, MD, MSDavid I. Buckley, MD, MPHFrom Oregon Health & Science University, Portland, OR 97239.Search for more papers by this author and Mark Helfand, MD, MSFrom Oregon Health & Science University, Portland, OR 97239.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-152-6-201003160-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Cook asserts that, in our systematic review and assessment of the body of evidence, we conclude that “routine screening of CRP cannot be recommended.” This is incorrect. We made no recommendations about routine screening. Rather, we presented our findings to the USPSTF, which is solely responsible for USPSTF recommendations.We found that CRP level is associated with coronary heart disease events and that adding CRP level to a global risk score in initially intermediate-risk persons reclassifies some patients. However, we also found that the benefit of reclassifying patients in this manner is uncertain.We agree that direct ...References1. Hlatky MA. Expanding the orbit of primary prevention—moving beyond JUPITER [Editorial]. N Engl J Med. 2008;359:2280-2. [PMID: 18997195] CrossrefMedlineGoogle Scholar2. 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 Scholar3. Helfand M, Buckley DI, Freeman M, Fu R, Rogers K, Fleming C, et al. Emerging risk factors for coronary heart disease: a summary of systematic reviews conducted for the U.S. Preventive Services Task Force. Ann Intern Med. 2009;151:496-507. [PMID: 19805772] LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Oregon Health & Science University, Portland, OR 97239.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 Emerging Risk Factors for Coronary Heart Disease: A Summary of Systematic Reviews Conducted for the U.S. Preventive Services Task Force Mark Helfand , David I. Buckley , Michele Freeman , Rongwei Fu , Kevin Rogers , Craig Fleming , and Linda L. Humphrey The Case for C-Reactive Protein as a Risk Marker for Coronary Heart Disease Nancy R. Cook Metrics 16 March 2010Volume 152, Issue 6Page: 406-407KeywordsC-reactive proteinsCholesterolClinical trialsConflicts of interestCoronary heart diseaseLow density lipoproteinPatientsRandomized trialsStatinsSystematic reviews ePublished: 16 March 2010 Issue Published: 16 March 2010 Copyright & PermissionsCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...