The Reticent Dr. Ridker

From the annual scientific session of the American College of Cardiology in Orlando.

Sunday, March 29, was arguably the best day of Dr. Paul M. Ridker’s distinguished career.

The father and champion of the hsCRP hypothesis–the idea that blood levels of the inflammatory marker high-sensitivity C-reactive protein is an important and modifiable risk factor for cardiovascular diseases–was part of two major reports on the subject delivered at the American College of Cardiology’s annual scientific session. Both reports came out of the JUPITER study, which examined the effect of the lipid-lowering drug rosuvastatin (Crestor) on hsCRP and on the rate of cardiovascular disease events like myocardial infarctions, strokes, and deaths. The study enrolled people with no history of cardiovascular disease who wouldn’t qualify for statin treatment based on current U.S. guidelines.

One report, previewed at a press conference by Dr. Ridker before his talk on the meeting’s main program the next day, delivered the money shot on hsCRP.  The new evidence showed that cutting hsCRP levels with the statin produced a beneficial effect that was similar to but completely independent of the drug’s effect on low-density lipoprotein (LDL) cholesterol. The finding will likely drive a shift in medical practice toward more hsCRP testing and put more people on statin treatment.

Dr. Paul M. Ridker

Dr. Paul M. Ridker (Photo by Mitchel Zoler)

The second report, delivered on Sunday by a colleague, was not as central to the hypothesis but carried its own jaw-dropping punch: A fairly potent statin regimen was capable of substantially cutting the rate of venous thromboembolism, a benefit that statins had never before been proven to have.

So, the logical question for Dr. Ridker was what all this means for the future roles of hsCRP and hsCRP screening.

His reply, one he’s delivered many times before, is “I can’t comment on screening.” That’s because he and his hospital, Brigham and Women’s in Boston, hold a patent on using inflammatory biomarkers like hsCRP in patient care.

When it comes to hsCRP, “My job is reporting the data; others figure out what guidelines should be,” Dr. Ridker says.

Undeniably a noble sentiment, but frustrating too when it comes from the guy who probably knows more about hsCRP than anyone.

—Mitchel Zoler @mitchelzoler

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Filed under Cardiovascular Medicine, Family Medicine, Internal Medicine

2 responses to “The Reticent Dr. Ridker

  1. Walter

    Hey Mitch,

    I was just doing an overview for two publications and came to the same question — why not say something about screening?

    You anwered it!


  2. Very interesting and educative article by you. Thanks.

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