Tests for C-reactive protein and cancer

The predictive powers of a cholesterol test only go so far. If the LDL is low, C-reactive protein may be a sign of impending heart problems.

The difference between knowing what is good for you and the realization can be enormous, especially when it comes to something like exercise. (Never underestimate the appeal of a sedentary lifestyle.) Many of us need a warning, some might say a little "kick in the pants, before we change our ways and get a healthy heartprogram.

For decades, cholesterol test, which served as a warning to many. A high level of LDL "bad" cholesterol was only necessary to alert people to change their habits. He has held this role for several reasons. People as evidence, because the results seem objective. reliable measurement of cholesterol and "easy and relatively cheap. It makes sense biologically. LDL cholesterol, the protein that contains a package wrapped in fat and cholesterol, tends to escape from thebloodstream and lodge in blood vessel walls, forming plaque that leads to the formation of blood clots and heart attacks.

It makes sense statistically. The correlation between lower LDL and reduce the chances of suffering a heart attack or developing other forms of heart disease is well documented. Exercise and dietary changes are good for the heart, because even low levels of LDL cholesterol.

But for all its virtues, cholesterol testing is a serious error. Research has shownthat only 50% of people who have heart attacks have high LDL. If LDL levels should be a warning, then is not going away half of those who could benefit from an alarm clock.

This shortage has two problems. The first and most obvious, most people are at risk of being lost. Then there is the need for a different test to "capture" those who slip through the fingers of the cholesterol test.

Second, because the detection of many emerging forget cholesterolheart attacks, suggests that cholesterol does not adequately explain heart disease.

Inflammation appears to be the explanation, and C-reactive protein (CRP), a byproduct of inflammation, can provide evidence.

Experts who study the blood vessels, plaque, and heart attacks in the smallest details are developing an explanation for inflammatory heart attacks. Describes a very different process of analogy clogged pipes. Blood vessels are not solid tubes, but the thin tubeslayers, the living tissue, some of which are very delicate. LDL cholesterol is not limited to deposit on the walls of the arteries than harm. And as injuries to other parts of the body, causing an inflammatory response. Swarms of cytokines, macrophages and other cells they expand and transform beaten deposits LDL cholesterol accumulation in foam cells laden with fat plugs sealed by fibrous collagen.

Other inflammatory molecules that can weaken a fibrous cap that eventually opens. L 'contents of the spill plate and activate clotting factors in the blood. A great form a clot. The result: a blocked artery and a heart attack.

If inflammation, says heart attack, then a test that helps doctors to measure inflammatory activity in blood vessels may be valuable. The PCR is nothing new to medical science. The protein was discovered more than 70 years.

The researchers soon realized that was part of the inflammatory immune response or as levelsincreased in response to a strep infection. In fact, doctors have used for decades CRP measurements for monitoring patients with lupus, rheumatoid arthritis and other conditions related to the immune system.

However, as a way to detect the risk of heart disease? It's been a different story. All the momentum and much of science to be behind the cholesterol test. Now, however, the PCR test appears ready to take off for several reasons.

People have heard or readreasoning behind it.

The explanation for inflammatory atherosclerosis and heart attacks has ran through the rarefied circles of research doctors and the public. Dozens of newspapers, magazines, newsletters and articles have been written about him. People are more likely to be tested, perhaps even a question if you have some knowledge of what is being measured and why. The same goes for doctors.

It s a good predictor of heart disease.

Even if the heartthe incidents were caused by inflammation, the PCR test would not be useful unless it has proven to be a good predictor. In other words, studies must demonstrate a strong correlation between high levels of C-reactive protein and the likelihood of suffering a heart attack.

In short, this is what a series of studies published in prestigious journals has shown. One, on November 14, 2002, New England Journal of Medicine, concluded that the CRP than LDL cholesterolpredictor of cardiovascular risk. In addition, the authors found that the two tests to identify high-risk groups to use both is better to rely on just one.

This is a better predictor of other measures of inflammation.

There are other ways to measure inflammation. But a study on March 23, 2000, New England Journal of Medicine concluded that CRP is a better predictor of cardiovascular events (myocardial infarction, stroke, bypasssurgery or angioplasty) compared with other inflammatory markers.

E 'sensitive.

Until recently, the evidence available to doctors are not able to measure low (below 10 milligrams per liter) CRP levels. The tests are sensitive enough to measure levels of 1 milligram per liter or less. This is a very exciting development because it is fairly minor differences in cardiovascular risk be solved w.

The test costs $ 12 - $ 16, and requires only a small amountof blood. In fact, the same blood sample could be sent to a laboratory for testing cholesterol and C-reactive protein.

No cuts before, doctors do not know how to interpret the results of the PCR test. Dr. Paul Ridker, Harvard researcher, was principal investigator of the most fundamental PCR studies and is co-inventor of patents. He says it is now possible to classify the levels of CRP in low, moderate or high.

Less than 1 milligram per liter of blood corresponds to alow risk of heart attack or other cardiovascular problems, 1.3 milligrams per liter corresponds to a moderate risk, and more than 3 milligrams, at high risk. These cuts may change with further research (as well as cholesterol), but are a starting point.

Imagine that your doctor tells you that um inflammation test innovative shows that have a disturbing level of an agent of the protein, but not much you can do about it. This test is not a popular or usefuleven if it were a perfect predictor of heart attacks.

A big reason behind the growing enthusiasm for testing is that levels of CRP can be lowered. Statins (Lipitor, Zocor, other brands) made its name with the reduction of LDL, research has shown that even lower levels of C-reactive protein. Exercise is a great way to reduce C-reactive protein level, weight loss also seems to work.

C-reactive protein "hawks" who now is the time when everyone should have the test andyou can get to replace cholesterol testing. "Doves" to say that simply is not enough evidence on how physicians should consider the high levels, although there is a relationship with cardiovascular risk.

As we go to press (2003), or the American Heart Association (AHA) or the American College of Cardiology has made a formal recommendation on C-reactive protein. AHA reviews written by leaders hint that you can draw a cross and the evidence suggests that people fall into aintermediate risk group because of his age (60 years), weight or blood pressure. AHA and other guidelines that affect how doctors use the PCR test in the next year. Ultimately, however, the fate of proof is on prospective randomized trials of interventions to reduce CRP still ongoing.

November 2002 Dr. Ridker comparative study of C-reactive protein and LDL cholesterol found that cardiovascular risk was actually higher for people with high CRP / low LDL group comparedfor low CRP / high LDL group. Clearly, cholesterol testing have lost people in the high CRP / low LDL group.

If the results hold, the PCR tests may be recommended for people with low levels of LDL. Because the test is cheap, only doctors could test for both right off the bat, instead of waiting for the results of cholesterol.

No evidence, no matter how good, to change anyone's health. That s what we do in response that counts. Statins have been apharmacists face in preventing heart disease, but the truth of old exercise, eat well, stay quiet and do not smoke. If the PCR test more people to follow that advice, then it may be useful.

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