In this presentation Dr. Ridker discusses new data from a large prospective study directly comparing the predictive value of different lipid measures, lipid ratios, Apolipoproteins A-1 and B-100, non-HDL cholesterol and hsCRP, for future cardiovascular events in women.

Major studies have indicated the importance of monitoring inflammation in addition to traditional risk factors for the prediction of cardiovascular events (1-3). In a newly published 10-year follow-up study of 15, 632 initially healthy U.S women, the analysis wasn't limited to LDL-cholesterol and hsCRP, for example, but a number of biomarkers and lipid ratios of interest were directly compared in their ability to predict cardiovascular events (4). These data on the relative risks associated with individual parameters and lipid ratios indicate not only their predictive power but also which ones might replace others as surrogate markers. Based on these findings Dr. Ridker discusses how a combination of total cholesterol, HDL cholesterol and hsCRP may be used for predicting first-ever cardiovascular events.

With regards to secondary prevention of cardiovascular events, Dr. Ridker also reviews important findings from the PROVE IT-TIMI 22 trial on the clinical relevance of achieved LDL cholesterol and CRP levels after treatment with statin therapy (5).

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After viewing this presentation the participant will be able to discuss:

- The predictive value of different CVD risk factors in women and clinical implications for prevention of first-ever cardiovascular events
- Statin treatment in the secondary prevention of cardiovascular events and the clinical relevance of achieved LDL cholesterol and CRP levels

1.Paul M. Ridker, M.D., Nader Rifai, Ph.D., Lynda Rose, M.S., Julie E. Buring, Sc.D., and Nancy R. Cook, Sc.D.Comparison of C-Reactive Protein and Low-Density Lipoprotein Cholesterol Levels in the Prediction of First Cardiovascular Events NEJM.2002;347:1557-1565.

2. Paul M Ridker, MD; Julie E. Buring, ScD; Nancy R. Cook, ScD; Nader Rifai, PhD. C-Reactive Protein, the Metabolic Syndrome, and Risk of Incident Cardiovascular Events: An 8-Year Follow-Up of 14 719 Initially Healthy American Women Circulation. 2003;107:391.

3. Shaista Malik, MD, MPH, Nathan D. Wong, PHD, FACC, Stanley Franklin, MD, FACC, Jose Pio, BS, Carol Fairchild, PHD and Roland Chen, MDCardiovascular Disease in U.S. Patients With Metabolic Syndrome, Diabetes, and Elevated C-Reactive Protein Diabetes Care 28:690-693, 2005.

4. Paul M Ridker, MD; Nader Rifai, PhD; Nancy R. Cook, ScD; Gary Bradwin, BS; Julie E. Buring, ScD. Non–HDL Cholesterol, Apolipoproteins A-I and B100, Standard Lipid Measures, Lipid Ratios, and CRP as Risk Factors for Cardiovascular Disease in Women JAMA. 2005;294:326-333.

5. Paul M Ridker, M.D., Christopher P. Cannon, M.D., David Morrow, M.D., Nader Rifai, Ph.D., Lynda M. Rose, M.S., Carolyn H. McCabe, B.S., Marc A. Pfeffer, M.D., Ph.D., Eugene Braunwald, M.D., for the Pravastatin or Atorvastatin Evaluation and Infection Therapy–Thrombolysis in Myocardial Infarction 22 (PROVE IT–TIMI 22) Investigators C-Reactive Protein Levels and Outcomes after Statin Therapy NEJM.2005;352:20-28.