May 5, 2009

Dear Friend,

We all keep up with our cholesterol these days, particularly the “bad” LDL linked to coronary artery disease. Now researchers have found another important marker—C-reactive protein (CRP)—that identifies more seemingly healthy people with elevated risk.  

Because of your interest in the Texas Heart Institute at St. Luke’s Episcopal Hospital, I write to tell you about our role in this important medical advance.

For a decade, physician scientists at the Institute have tested patients’ blood for CRP. When inflamed, the liver or an artery wall (such as a coronary artery that supplies blood to the heart) produces this substance.

A research team led by me and Dr. Edward Yeh, who is the McNair Scholar at the Texas Heart Institute and Chief of Cardiology at The University of Texas M.D. Anderson Cancer Center, found that CRP causes certain cells that line the blood vessels to attract the floating inflammatory cells, contributing to formation of arterial deposits known as plaques. When these plaques rupture, they often cause heart attacks and strokes. Traditional LDL screening misses high-risk patients with relatively normal LDL levels, but high blood CRP levels.
    
The next step was to conduct human trials to determine whether lowering CRP levels in the blood would reduce the risk of heart attacks and strokes. We helped Dr. Paul M. Ridker at Harvard Medical School begin and interpret a trial of a statin medicine for patients with elevated CRP levels. More than 17,000 patients in 26 counties participated in this trial, known as the JUPITER Trial. I served on the steering committee. 

The trial was set to run for five years, but ended sooner because early results were clear and positive. As expected, the study linked an elevated CRP level with an increased risk of heart attack, stroke, and cardiovascular death. The research also showed that statin therapy reduced the risk of heart attack by 54% and the risk of stroke by 48% in patients with high CRP levels. 

Last November, these results were presented at the annual meeting of the American Heart Association. The same findings also appeared in the New England Journal of Medicine. In response, many physicians now test for both CRP and LDL cholesterol. By identifying more patients with otherwise undetected coronary artery disease and treating them with statin medicines, physicians can prevent many heart attacks and strokes.

This is an example of how research at the Texas Heart Institute helps improve patient care and prevent cardiovascular disease around the nation and throughout the world. Our physicians and scientists work tirelessly to unfold the mysteries of the heart and circulatory system, understand the mechanisms of disease, and find effective treatments. 

We do not do this alone. Generous individual and corporate donors share the honor for every medical breakthrough at the Institute. 

To learn more about our research and education programs and to find ways to help, please contact Mr. Marc C. Mattsson, Chief Executive Officer of the Texas Heart Institute, at 832-355-3792 or email him at mmattsson@heart.thi.tmc.edu.

Sincerely yours,

 
James T. Willerson, MD
President and Medical Director

Contact Dr. Willerson