It May Not Be A Great Test — But It's My Test And I'm Sticking With It

April 2, 2004

by Merrill Goozner

With a quarter million Americans with normal cholesterol levels dropping dead of heart attacks each year, it would be nice to have a simple test that could predict a person’s vulnerability. Some medical scientists think they’ve come up with the answer.

It’s called C-reactive protein, an inflammatory agent in the blood that springs into action when something in the body gets damaged. Proponents of the C-reactive protein thesis think people with elevated levels are at risk of sudden heart attacks. They’ve published a few studies, and garnered lots of attention over the past few years by suggesting a new biomarker of heart failure risk ( the next cholesterol ) is at hand. A number of physicians have even begun routine testing of their patients for C-reactive protein.But today’s New England Journal of Medicine threw a damper on the C-reactive protein thesis. A British study suggested the marker is at best a moderate predictor of sudden heart failure. “Recommendations regarding its use in predicting the likelihood of coronary heart disease may need to be reviewed,” the authors concluded.

Proponents immediately leaped to its defense. The most often quoted source was Dr. Paul Ridker of Harvard Medical School and chief of the cardiovascular unit at Brigham and Women’s Hospital in Boston. He told the Associated Press, the Wall Street Journal and other publications that inflammation is a strong risk factor for sudden heart failure and the C-reactive protein test is the best way to spot it. “My concern is that even in the face of overwhelming evidence that this inexpensive blood test works, we are at risk of moving backward rather than forward,” he said.

A healthy debate among research scientists? Perhaps. And, if you’re a certain age and person at risk (maybe your dad died of a heart attack), you’re probably thinking, the heck with those Brits, it’s time to go get the test.

But let’s play a little mind game. What if I told you Dr. Paul Ridker of Harvard owns the patent to using C-reactive protein as a biomarker of heart disease and it’s licensed to companies making the test. And what if I told you his research has been funded by drug companies that make statins, which lower cholesterol and may be used to combat high levels of C-reactive protein.

Would it change your mind? Would it at least give you pause? Unfortunately, you won’t get the answer to this mind game by reading the papers. Unlike medical journals, news outlets rarely report conflicts of interest when they quote prominent researchers. But you can get the answer yourself. Just go to the Patent and Trademark Office website ( and put patent number 6,040,147 into the search engine.

You might be shocked by what it turns up. But in this age of hyper-medical entrepreneurialism, you won’t be surprised.

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