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.