C-reactive protein and cholesterol are equally strong predictors of cardiovascular risk and both are important for quality clinical care.

نویسندگان

  • Paul M Ridker
  • John J P Kastelein
  • Jacques Genest
  • Wolfgang Koenig
چکیده

Physicians do not measure biomarkers simply to predict risk. Rather, they do so to better target therapy and improve the lives of their patients. Thus, when considering the use of any biomarker for cardiovascular risk prediction in primary prevention, thoughtful clinicians, and those writing guidelines should insist that two fundamental questions be answered affirmatively. First, is there clear evidence that the biomarker of interest predicts future cardiovascular events independent of other risk markers? And secondly, is there clear evidence that those identified by the biomarker of interest benefit from a therapy they otherwise would not have received? No imaging biomarker can answer these questions affirmatively, nor can a variety of plasma biomarkers such as lipoprotein(a) or triglycerides. As we will discuss below, the answer to both of these questions is clearly ‘yes’ for C-reactive protein as well as for cholesterol. Yet, while recent European Society of Cardiology guidelines for the prevention of heart disease strongly endorse cholesterol screening, those same guidelines are silent on C-reactive protein.

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عنوان ژورنال:
  • European heart journal

دوره 34 17  شماره 

صفحات  -

تاریخ انتشار 2013