Office of
Public Affairs

Baylor College
of Medicine
One Baylor Plaza - 176B
Houston, TX 77030
Telephone:
  (713) 798-4712
Fax:
  (713) 798-3692
email: pa@bcm.tmc.edu

Photos Available Upon Request

Comments, Suggestions?

C-reactive protein - a predictor of stroke, heart attack?
By John Tyler

Christie Ballantyne, MD, director of the Center for Cardiovascular Disease Prevention, and Mine-Yine Liu, PhD, postdoctoral associate, look over data

Could a new blood test give physicians the upper hand in predicting stroke or heart attack in patients who show no other risk factors?

Researchers at the Center for Cardiovascular Disease Prevention at Baylor College of Medicine and The Methodist DeBakey Heart Center see the test as an indicator that may help identify risk in patients for whom other factors are less clear.

The test identifies levels of C-reactive protein in the blood. C-reactive protein is an indicator of inflammation. High levels of C-reactive protein have been linked to increased risk of heart attack, stroke, and type 2 (non-insulin dependent) diabetes.

Researchers have found the new high sensitivity test to be helpful in identifying potential problems in those who fall neither into a "low risk" or "high risk" category using the traditional risk factors. The C-reactive protein test is only one of several new markers Baylor scientists are researching in the lab.

"C-reactive protein is not a substitute for the factors we've been telling people to keep an eye on," said Christie Ballantyne, MD, director of the center and a professor in Baylor's department of medicine. "The major risk factors are still age, hypertension, diabetes, high density lipoprotein (the so-called good) cholesterol and cigarettes. We still look at those five factors and we determine the intensity of therapy based on them."

However, he said, there are millions of people who fall in the "gray zone" because their traditional risk factors put them in an equivocal area that is neither high nor low. This could be a test to help that patient and doctor determine they need a more aggressive treatment.

"If you have low cholesterol and have no risk factors, this is probably not a test that you need," he said. "If you have all the risk factors or already have heart disease or diabetes, again, this is probably not a test you need. However if you have even a borderline cholesterol or low high density lipoprotein with some risk factors this may be a useful test"

In January 2003, the American Heart Association and the federal Centers for Disease Control and Prevention in Atlanta, Ga., issued guidelines for the use of C-reactive protein testing by physicians in practice. The group suggests that screening should be reserved for people with moderate cardiovascular risk, with 10-year coronary heart disease risk in the range of 10% to 20%, and that it should not replace assessment for major risk factors. Screening should consist of two C-reactive protein measurements, fasting or non-fasting, approximately two weeks apart. Values higher than 10 milligrams/liter may suggest active infection or inflammation.

Ballantyne notes, however, that the test isn't flawless. "The problem is that C-reactive protein levels rise in the presence of any acute illness," he said. "A cold can send your levels up."

In the coming years, Ballantyne and his research team are hoping to develop a complete panel of new markers, including C-reactive protein, that are associated with inflammation or atherosclerosis. These markers will be used to identify those heading toward a problem early.

"I really think in the next four or five years we'll have this complete panel of markers ready to use," he said.

© Copyright 2003 Baylor College of Medicine. All Rights Reserved.