New risk factor for heart disease suggests more should be on statins

Nov 10 2008

Canadian scientists have discovered a new risk factor for cardiovascular disease and the significance of their discovery was so conclusive that the clinical trial was stopped before its scheduled completion date.

The international team of scientists have discovered that having high levels of a particular protein - high-sensitivity C-reactive protein (hs-CRP) - puts patients at increased risk of developing cardiovascular disease.

The team say this risk decreases by up to 44% if the patients are treated with statin medications.

The team included scientists from the McGill University Health Centre (MUHC) and McGill University who were taking part in the international JUPITER Project and they say the risk of cardiovascular disease due to increased hs-CRP levels has been greatly underestimated until now.

According to Dr. Jacques Genest, of the Research Institute of the MUHC, their results show that this is an extremely important indicator that doctors must in future consider.

Dr. Genest says hopefully the study will prompt a review of current clinical practices, especially in terms of screening and prevention in adults but he says more research is needed to establish specific standards.

The JUPITER study involved 17,802 patients from 27 different countries, all with normal levels of cholesterol (LDL-c) and high levels of hs-CRP, who according to current standards, were not considered "at risk" for cardiovascular events, and were therefore not receiving any treatment.

During the study the participants received a daily dose of the statin drug rosuvastin with striking results - a 44% decrease in the risk of cardiovascular disease and a 21% decrease in mortality.

The international study could revolutionize treatment options and Dr. Genest says the results surpassed predictions and were such that the study was stopped before its scheduled completion, because the benefit of the treatment was so great and needed to be presented to the medical community as soon as possible.

Statins have a cholesterol-lowering effect and are currently used to prevent cardiovascular disease in patients who are at-risk due to high LDL-c levels - however cardiovascular disease is also caused by vascular inflammation, which is marked by levels of hs-CRP and this study shows that statins act on both cholesterol and inflammation, an effect that has long been suspected but not proven.

The research was funded by drug company AstraZeneca.

Dr. Genest is Director of Cardiology at the MUHC and Director of the Cardiovascular Genetics Laboratory at the Research Institute of the MUHC and also holds the Novartis Chair in Medicine at the Faculty of Medicine of McGill University.