This blog tracks updates to the Blood Sugar 101 Web site.

Friday, April 8, 2011

Statin effectiveness doess not correlate with CRP in people at very high risk of heart attack

Page changed: A1c and Post-Meal Blood Sugars Predict Heart Attack

Added the following reference to this new study to the discussion of the relationship of CRP and statin effectiveness.

A larger analysis published in 2011 in the Lancet seems to contradict this finding because it found statins prevented a significant number of cardiovascular events regardless of CRP level.

C-reactive protein concentration and the vascular benefits of statin therapy: an analysis of 20 536 patients in the Heart Protection Study. Heart Protection Study Collaborative Group. The Lancet Volume 377, Issue 9764, Pages 469 - 476, 5 February 2011 doi:10.1016/S0140-6736(10)62174-5

However, that is not quite what the study really showed, because all the participants in that study were at high risk of heart attack. The earlier study, in contrast, was a study of people who did not have a higher than normal risk of heart attack.

No one argues that statins don't help people who are at very high risk of heart attack--but it is a mistake to include people with diabetes who have been in excellent control for years and maintain A1cs below 6% in that group. The Lancet study treated people with a diabetes diagnosis as "high risk" but in the UK people with diabetes are considered to be in "excellent control" if they have A1cs approaching 8% and those wishing to achieve tighter control receive little support, no medication, and often no test strips.

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