Acute Coronary Syndromes & Diabetes: Is Intensive Lipid Lowering Therapy Beneficial?

In the setting of acute coronary syndrome (ACS), the risks of death and ischemic complications are high in diabetic patients, and given that dyslipidemia is a major contributing factor to poor outcomes it is of interest to observe the effects of lipid-lowering...(more)

Diabetes Treatments and Inflammatory Markers

It is by now well recognized that atherosclerosis is an inflammatory disease and diabetics appear to be disproportionately affected by both cardiovascular disease and inflammation. What is the effect of chronic inflammation on the pathophysiology of diabetes? What...(more)

Inflammation, Diabetes and Cardiovascular Disease: Further Support to the "Common Soil" Hypothesis?

Various biomarkers indicate immune activation in type 2 diabetes and atherosclerosis, and some of these inflammatory markers including C-reactive protein have been shown to predict the incidence of cardiovascular events (1) and diabetes (2). The vessel wall and...(more)

Association of hsCRP with Later Stage Beta-Cell Dysfunction and Insulin Resistance in Patients with Type 2 Diabetes

High-sensitivity C-reactive protein (hsCRP) was shown in large epidemiological studies to predict the risk of cardiovascular disease in apparently healthy individuals (1). In this presentation Dr. Pfutzner presents data from the IRIS-II study showing that hsCRP may...(more)

CRP, Inflammation, and its Relationship to Cardiovascular Disease, Metabolic Syndrome and Type 2 Diabetes

In this presentation Dr Ridker reviews the use of high-sensitivity C-Reactive Protein (hs-CRP) as a prognostic indicator of myocardial infarction, stroke and type 2 diabetes; the added prognostic information CRP provides in patients with the metabolic syndrome, the...(more)

Differential Effects of Rosiglitazone and Metformin on Inflammation and Subclinical Atherosclerosis in Patients with Type 2 Diabetes

In this talk Prof. Taylor presents the results of the CHD (Coronary Health in Diabetics) study, a randomized clinical trial on rosiglitazone vs. metformin in type 2 diabetic patients. The insulin-sensitising antidiabetic agent metformin was shown to reduce...(more)

CRP in Heart Failure

High-sensitivity C-reactive protein (hs-CRP) is predictive of future cardiovascular events in apparently healthy individuals but its role in heart failure has not been extensively studied. In the Valsartan Heart Failure Trial (Val-HeFT), the efficacy and safety...(more)

C-reactive Protein and Other Inflammatory Markers in Heart Failure

C-reactive protein (CRP) predicts future cardiovascular events in apparently healthy individuals, but what is the significance of CRP levels in patients with heart failure? Few studies have actually been published in this area, however CRP is increased in heart...(more)

Inflammation and Thrombosis

Atherosclerotic plaques can remain stable indefinitely, but in some cases the plaque changes abruptly leading to formation of a thrombus or blood clot blocking the coronary artery. Dr. Crea describes the role of T-cell activation in events leading to thrombus...(more)

C-Reactive Protein and Statin Therapy in Atrial Fibrillation

In this presentation Dr. Dernellis talks about the effects of statin therapy on C-reactive protein (CRP), in relation to atrial fibrillation (AF). Recent findings indicate a mechanistic link between inflammatory processes and the development of AF, and this link...(more)

New Perspectives on Treating CVD in Multicultural/multiethnic Patient Populations

In this presentation Dr. Ferdinand talks about cardiovascular disease in different racial/ethnic groups and new results from the ARIES (African American Rosuvastatin Investigation of Efficacy and Safety) trial. African Americans have been found to have a higher...(more)

Can We Better Manage and Prevent CHD in Ethnic and Minority Populations?

Cardiovascular disease is the leading cause of death in the U.S., with rates of cardiovascular death, and annual rates of first myocardial infarction by age being especially high in blacks, and striking differences seen in black women compared to white women (1)....(more)

Efficacy of Statin Therapy in African American Patients with Hypercholesterolemia: Results from the ARIES Trial

In this presentation Dr. Ferdinand presents data from the ARIES (African American Rosuvastatin Investigation of Efficacy and Safety) Trial. ARIES is the largest prospective trial to date comparing lipid-modifying treatments in African Americans. Over 700...(more)

Endothelial Function and Inflammatory Activation

In this presentation Dr. Fichtlscherer talks about endothelial function in relation to C-reactive protein (CRP), a marker of systemic inflammation. Endothelial dysfunction plays a key part in vascular disease, and Dr. Fichtlscherer describes the process of...(more)

Inflammation and Atherosclerosis - Mechanisms and Mediators

In recent years, atherosclerosis has come to be understood as an inflammatory disease, and several markers of inflammation such as C-reactive protein are indicators of risk for future heart disease (1). Innate immunity involving pattern recognition receptors is...(more)

C-Reactive Protein: Marker or Mediator?

In this presentation Prof. Kastelein shows some data on the effects of recombinant human CRP infusion into healthy human volunteers. In vitro and in vivo effects of CRP suggest that more than being a predictor of future cardiovascular risk, it is also a mediator of...(more)

Beyond LDL-C - Inflammation as a New Target for Therapy

In this presentation Dr. Koenig discusses the potential for inflammation as a target to be addressed in addition to LDL cholesterol (LDL-C) in patients with coronary heart disease. Statins not only lower LDL-C but also have other antiatherosclerotic properties...(more)

C-Reactive Protein – A Critical Cardiovascular Risk Marker

In this presentation Dr. Koenig discusses the mounting evidence in support of C-reactive protein (CRP) as an important risk factor for cardiovascular disease (CVD). Traditional risk factors are a useful first step in determining who could be at risk for a...(more)

Global Risk Evaluation in Europe, the Impact of Scoring, and the Potential Incremental Value of CRP

Global risk assessment for cardiovascular disease entails examination of all the available risk factors. The Framingham Risk Score, the Munster Heart Study (PROCAM) risk score and the European Society of Cardiology (SCORE Project) risk score are important examples...(more)

Association between Physical Activity, Lipid Lowering Therapy and Inflammatory Markers

In this presentation Dr. Daniel Konig from Freiburg, Germany, talks about the effects of physical activity and lipid-lowering therapy on high-sensitivity C-reactive protein (hs-CRP) levels in patients with coronary heart disease. "Inflammatory processes within...(more)

C-Reactive Protein as a Mediator of Atherosclerosis in Heart Transplantation

During this presentation Dr. Labarrere discusses the role of CRP as a risk marker for cardiac allograft vasculopathy following human heart transplantation. The development of transplant-associated atherosclerosis is commonly associated with allograft loss or...(more)

CRP in Acute Coronary Syndromes - State of the Art 2005

Unstable coronary disease is heterogeneous in etiology and prognosis. Different factors including inflammation can precipitate acute coronary syndromes, and a growing body of evidence supports the role of inflammation in atherogenesis and also thrombosis in some...(more)

Early Effect of Statins in Patients with Coronary Artery Disease and High C-Reactive Protein

In this presentation Dr. Muhlestein presents longitudinal data from the LDS Hospital in Utah, relating to CRP as a predictor of early benefit in patients with coronary artery disease receiving statin therapy. In an initial study published by Horne et al., blood...(more)

C-Reactive Protein, LDL Cholesterol Reduction and the Progression of Coronary Disease

In this presentation Dr. Nissen presents new data from the REVERSAL (Reversal of Atherosclerosis with Aggressive Lipid Lowering) trial, showing the effects of intensive versus moderate statin treatment on the rate of progression of atherosclerosis in patients with...(more)

CRP Reduction, LDL Reduction, and Cardiovascular Event Rates After Initiation of Rosuvastatin: The JUPITER Trial

Dr Ridker discusses new findings from the JUPITER trial which were initially released at the American College of Cardiology meeting in March ‘09. As was previously reported in the New England Journal of Medicine, treatment with rosuvastatin significantly...(more)

The JUPITER Trial Results - A Randomized Trial of Rosuvastatin in the Prevention of Cardiovascular Events Among 17,802 Apparently Healthy Men and Women With Elevated Levels of C-Reactive Protein (hsCRP)

Dr. Ridker presents findings from the JUPITER trial, as newly released at the American Heart Association's Scientific Sessions in New Orleans. The JUPITER (Justification for the Use of statins in Prevention: an Intervention Trial Evaluating Rosuvastatin) trial,...(more)

LDL-C vs hsCRP vs HDL-C: What is the Primary Driver of Benefit?

When considering biomarkers such as LDL-C, hsCRP and HDL-C, it is of interest to know their usefulness for predicting the risk of future vascular events, and for monitoring drug effectiveness. There is data to suggest that hsCRP may be a better predictor of the...(more)

A Comparison of hsCRP and Lp-PLA2 as Biomarkers to Assist in the Detection and Treatment of Cardiovascular Disease

The use of suitable biomarkers to enhance risk stratification of those at intermediate risk from global risk assessment for cardiovascular disease has an important role, since a large proportion of all cardiovascular events occur among those at intermediate risk....(more)

Should I Use Biomarkers in Assessing Cardiovascular Risk? Where did we start, where are we now, and where are we going?

In this presentation Dr. Ridker talks about biomarkers and cardiovascular risk, and where high-sensitivity C-reactive protein (hsCRP) may play a role clinically. Several biomarkers have been independently associated with the future risk of myocardial infarction...(more)

Prediction and Prevention: Where might hsCRP Fit In?

The prevalence of conventional risk factors in patients with coronary heart disease is not uniform. Dr. Ridker discusses the Framingham risk score, which is used to predict the risk of cardiovascular events in patients and to determine whether therapy should be...(more)

Use of Surrogate Outcomes, Surrogate Endpoints, and Biomarkers in Randomized Clinical Trials of Cardiovascular Disease: Does hsCRP Have A Role

In this presentation, Dr. Ridker explores three questions: Can we rely on surrogate outcomes in clinical trials? Can we rely on surrogate endpoints in clinical trials?..And if not, is there any use for biomarkers such as C-reactive protein (CRP) in the phase III...(more)

Non-HDL Cholesterol, Apolipoproteins A-1 and B-100, Standard Lipid Measures, Lipid Ratios, and CRP as Risk Factors for Cardiovascular Disease in Women

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...(more)

Should We Measure hsCRP After Starting Statin Therapy? Update 2005

With regards to assessment of cardiovascular risk, hsCRP levels add prognostic information to that obtained from the Framingham risk score (1). Statin drugs are cholesterol-lowering agents that also lower CRP levels (2), and the Cholesterol and Recurrent Events...(more)

C-Reactive Protein (hsCRP), Inflammation, and Cardiovascular Risk: Why the VAL-MARC Trial?

As early as 1997 it was reported that baseline high-sensitivity C-reactive protein (hs-CRP) levels predicted the risk of heart attack and stroke in apparently healthy men (1). These findings were confirmed in a large study of healthy women, which additionally...(more)

CRP, Statins, and Coronary Risk: Why the JUPITER Trial?

In this presentation Dr Ridker gives an update on the role of high sensitivity C-Reactive Protein (hs-CRP) in predicting the risk of heart attack and stroke, and the role of statin therapy in modulating that risk. CRP, a marker of inflammation, has become a...(more)

Inflammation and Atherosclerosis

Inflammation plays an important role in both the initiation and progression of atherosclerosis. The human arterial endothelium is complex organ that functions to prevent blood clot formation, producing anti-coagulant and anti-inflammatory molecules. When LDL...(more)

Clinical Application of C-Reactive Protein Across the Spectrum of Acute Coronary Syndromes

High hsCRP levels have been found to be associated with poor cardiovascular outcomes in patients with acute coronary syndrome (ACS). There are however few data and some conflicting data with regards to ST elevation MI, the full spectrum of ACS, specific subgroups...(more)

The Relationship Between C-Reactive Protein, B-type Natriuretic Peptide, and Hospitalization for Heart Failure after Acute Coronary Syndromes in the PROVE IT-TIMI 22 Trial

In patients with an acute coronary syndrome (ACS), heart failure is an important cause of morbidity and mortality. In a meta-analysis of four trials including the Pravastatin or Atorvastatin Evaluation and Infection Trial–Thrombolysis In Myocardial Infarction 22...(more)

Tissue Resident C-Reactive Protein in Degenerative Aortic Valves

In this presentation Dr. Skowasch talks about valvular heart disease, in particular aortic stenosis. Patients with aortic stenosis can have a long asymptomatic period, however once symptoms develop the prognosis is poor (1). According to the ACC/AHA 2006...(more)

Correlation of systemic inflammation with local inflammatory activity in non-culprit lesions

In recent years, new information about the morphological and functional characteristics of vulnerable atherosclerotic plaques has become available, as well as various diagnostic tools which recognize these features. In Part I of the presentation Dr. Toutouzas...(more)

Favorable effect of statins on local inflammatory activation in non-culprit lesions of patients with multivessel coronary artery disease

Recently, new insights have become available into how anti-inflammatory effects of statin treatment impact on what happens within the coronary arteries. As seen in the REVERSAL trial, for example, a reduction in systemic inflammation, as indicated by the level of...(more)

Markers of inflammation and hypercoagulation in CAD

Inflammation is recognized as playing a major role in atherosclerosis (1), and markers of inflammation have been associated with the risk of future cardiovascular disease. With regards to the clinical application of inflammatory markers, the American Heart...(more)

Inflammation and Atherosclerosis – Role of CRP

Inflammatory biomarkers are robust predictors—not necessarily of plaque burden—but of the propensity of a plaque to rupture, according to Dr. Verma. Traditionally, risk factors such as cholesterol and diabetes have been used to predict the risk of vascular disease....(more)

How to Predict Your Risk of Heart Attack or Stroke: The Reynolds Risk Score - Bringing hsCRP and Genetics to Clinical Practice

What is the actual prevalence of major risk factors in patients with coronary heart disease? A study by Khot et al. published in the JAMA in 2003 revealed that about 60 percent of these patients have only one or none of the conventional risk factors such as...(more)

The Association Between Pre-hypertension Status and Inflammatory Markers Related to Atherosclerotic Disease

In this presentation Dr. Chrysohoou discusses the findings from the ATTICA Study showing the relationship between various inflammatory markers and pre-hypertension status in cardiovascular disease-free adults. Hypertension is a major risk factor for several...(more)

Arterial Stiffness is Related to Systemic Inflammation in Essential Hypertension

Arterial stiffness has prognostic value in the general community and in those with hypertension, and there has been growing evidence recently of an association between systemic inflammation and arterial stiffness. Is systemic inflammation important in the...(more)

Inflammation and Arterial Stiffness

Inflammation plays a crucial role in all stages of atherosclerosis, and various inflammatory markers have been studied to date. C-reactive protein (CRP) is the most well-studied, says Dr. Kullo, due to its ease of measurement and stability in stored samples....(more)

CRP as a Predictor of Hypertension and the Metabolic Syndrome

Elevated high-sensitivity C-reactive protein (hs-CRP) levels have been found to be significantly related to an increased risk of coronary heart disease in both men and women (1), but how does low-grade inflammation reflected as elevated hs-CRP relate to...(more)

Valsartan, Blood Pressure Reduction, and C-Reactive Protein: Primary Report of the Val-MARC Trial

In this presentation Dr. Ridker discusses new findings from the Val-MARC (Valsartan – Managing BP Agressively and Evaluating Reductions in hsCRP) trial that were presented at the 21st Annual Scientific Meeting of the American Society of Hypertension, in New York....(more)

Relation of Microalbuminuria to Adiponectin And Augmented C-reactive Protein Levels In Men With Essential Hypertension

Microalbuminuria, or a urinary albumin excretion rate of 30 to 300 mg/24 hours, is an independent predictor of cardiovascular disease (CVD) in hypertensive patients (1), and is thought to be the consequence of generalized endothelial damage along the vascular tree,...(more)

Diverse Associations of Microalbuminuria With C-Reactive Protein, Interleukin-18 and Soluble CD 40 Ligand in Male Essential Hypertensive Subjects

Hypertension leads to target organ damage not only through the effect of increased haemodynamic load, but also through increased angiotensin II expression, decreased nitric oxide production and an enhanced subclinical inflammatory process. Microalbuminuria, or...(more)

Obesity, Dyslipidemia and Inflammation

In this presentation Dr. Eckel discusses various pathways involved in the genesis of metabolic syndrome and options for the treatment of obesity, dyslipidemia and inflammation. The metabolic syndrome is thought of as a disorder of insulin resistance, which in...(more)

Transforming the Paradigm for the Metabolic Syndrome

In this presentation Prof. Haffner talks about the metabolic syndrome and its components in relation to diabetes and CVD risk, and approaches to therapy. Even before the clinical diagnosis of type 2 diabetes there is an already increased risk of CVD as was seen...(more)

The Metabolic Syndrome and Inflammation

Dr. Haffner gives a brief overview of the metabolic syndrome and inflammation. Environmental factors, insulin resistance and inflammation are all thought of as causes of the metabolic syndrome. Metabolic syndrome components include dyslipidemia, high blood...(more)

CRP, the Metabolic Syndrome and Cardiovascular Diseases

What is it about the metabolic syndrome that predisposes individuals to an increased risk of cardiovascular events? Which is the more important factor in the elevated cardiovascular risk of pre-diabetics; high circulating glucose levels or insulin resistance? How...(more)

Impact of Metabolic Syndrome on Medical Practice

Metabolic syndrome has a high prevalence in the United States, and has been shown to be predictive of coronary heart disease and type 2 diabetes. In this presentation Dr Nesto will describe how levels of C-Reactive Protein (CRP), a marker of inflammation, can add...(more)

CRP, Metabolic Syndrome and Hypertension: Lessons from the Kuopio Ischemic Heart Disease Study (KIHD)

In this presentation Prof. Niskanen talks about C-reactive protein (CRP) as a predictor of metabolic syndrome, type 2 diabetes and hypertension, and the role of mediating factors. The metabolic syndrome is a cluster of abnormalities increasing the risk of...(more)

Gout and the risk for coronary artery disease: The MRFIT study

How strong is the link between gout and coronary artery disease? In this educational activity, Dr. Krishnan discusses the Multiple Risk Factor Intervention Trial (MRFIT), which was designed to isolate gout as a risk factor in order to study this relationship....(more)

Aspirin and Statins in RA - The evidence

Rheumatoid arthritis (RA) is an inflammatory condition, known to be associated with increased risk for coronary artery disease (CAD). Aspirin and statins are among the most effective treatments for preventing and/or treating coronary artery disease, says Dr....(more)

IL-6, hsCRP, and Cardiovascular Risk: Relevance to Rheumatoid Arthritis

Similarities in the inflammatory response seen in atherosclerosis and in rheumatoid arthritis (RA) have raised interest for the study of the molecular mechanisms of rheumatoid arthritis, in order to potentially learn more about the mechanisms of atherosclerosis....(more)

Genetic Determinants of Inflammation: Focus on CRP

Elevated levels of systemic inflammation have been associated in large studies with increased vascular risk. Addition of high-sensitivity C-reactive protein (hsCRP) measurements to low-density lipoprotein (LDL) cholesterol, was previously shown to enhance risk...(more)

Inflammation and Novel Risk Markers – From Acute Coronary Syndromes to Primary Prevention

There are different diagnostic strategies for the evaluation of acute chest pain, each of which is based on a different pathophysiology. Dr. Ridker, however, suggests that there are better ways to deal with risk stratification in acute ischemia. The multimarker...(more)

Laboratory Issues in hs-CRP Evaluation

Various blood markers of inflammation have been found to be useful in assessing cardiovascular risk, or as prognostic tools in patients with acute coronary syndromes. The unique properties of C-reactive protein (CRP) have allowed it to become used in clinical...(more)

Laboratory Assessment of Inflammation

In this presentation Dr. Tracy gives a brief history of the development of markers of inflammation and discusses the ability of inflammatory markers to predict disease. Important issues in assay development and use are discussed, as well as future directions for...(more)

C-Reactive Protein and Lipid-Lowering Therapy

As high-sensitivity C-reactive protein levels provide prognostic information in addition to traditional risk factors for coronary heart disease, it is of interest to know how medications can be used to lower CRP. In this presentation Dr. Ballantyne presents...(more)

Treating Both Cholesterol and Inflammation

Numerous studies have shown that cholesterol-lowering treatment with statin drugs reduces the risk of a future heart attack or death. One of these studies, the PROVE IT-TIMI 22 trial, has recently provided much new information on how statin therapy lowers that risk...(more)

An Overview for Beginners on High-Sensitivity C-Reactive Protein (hs-CRP)

In this presentation Dr. Koenig addresses some commonly encountered questions about C-reactive protein (CRP) and the significance of high sensitivity CRP (hs-CRP) testing in clinical practice. CRP is a molecule produced by the liver in response to inflammation,...(more)

Inflammation and Atherosclerosis

Heart attacks are a major cause of death around the world, and much research has focused lately on the underlying causes of heart attacks, and how this knowledge can be used in medical practice to help prevent the occurrence of such events. “Atherosclerosis” or...(more)

Blood Pressure, Blood Pressure Therapy, and C-Reactive Protein (hsCRP): A Patient Based Update

Inflammation is a process by which the body heals itself, however, chronic inflammation is implicated in some disease states, such as rheumatoid arthritis. Recently, atherosclerosis has also come to be understood as an inflammatory disease (1). C-reactive...(more)

Do patients on statin therapy need hsCRP measured? Update January 2005

High sensitivity C-reactive protein (hsCRP) is a measuement of inflammation, and numerous large studies have shown that high hsCRP levels increase the risk of having a future heart attack or stroke. As a result of these data, doctors can now use hsCRP measurements...(more)

An Introduction to High-Sensitivity C-Reactive Protein (hs-CRP) for Patients: Can We Better Predict Heart Attack and Stroke?

In this presentation Dr. Ridker addresses the question of whether high-sensitivity C-reactive protein (hs-CRP) can be used to better predict the risk of heart attack and stroke. High blood pressure, smoking, diabetes and high cholesterol are classical risk...(more)