{"id":1824,"date":"2018-03-09T00:54:53","date_gmt":"2018-03-09T00:54:53","guid":{"rendered":"http:\/\/cardiologynownews.org\/?p=1824"},"modified":"2018-03-23T19:48:39","modified_gmt":"2018-03-23T19:48:39","slug":"does-magnitude-of-crp-level-reduction-correlate-with-cardiovascular-mortality","status":"publish","type":"post","link":"https:\/\/cardiologynownews.org\/?p=1824","title":{"rendered":"Does Magnitude of CRP Level Reduction Correlate With Cardiovascular Mortality?"},"content":{"rendered":"<p>In a recent study published in <a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(17)32814-3\/fulltext\" target=\"_blank\" rel=\"noopener\"><em>The\u00a0Lancet<\/em><\/a>, it has been found that the magnitude of reduction in C Reactive Protein (CRP) levels due to treatment with Canakinumab, an interleukin 1\u03b2 targeting monoclonal antibody, may directly correlate with a decrease in major cardiovascular events in post-myocardial infarction (MI) patients, even in the absence of an alteration in LDL levels.<!--more--><\/p>\n<p>Previous studies have shown that Canakinumab decreases inflammation and cardiovascular mortality without altering lipid levels. However, the correlation of reduced CRP levels and cardiovascular event reduction was yet to be determined. To address this, Ridker and his colleagues recently published the results of a secondary analysis of the CANTOS trial in The Lancet.<\/p>\n<p>A total of 10,061 stable patients with a history of MI were enrolled in the Canakinumab Anti-inflammatory Thrombosis Outcomes Study (CANTOS) and treated with placebo or one of three doses of Canakinumab (50, 150 or 300mg) administered subcutaneously every three months.\u00a0 The primary endpoint of the study was a composite of major adverse cardiovascular events including cardiovascular death, stroke and recurrent MI. Additional endpoints encompassed hospitalization for unstable angina, all-cause, and cardiovascular mortality.\u00a0 The median follow-up period was\u00a0<span style=\"font-family: Merriweather, serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 300;\">3.7 years.<\/span><\/p>\n<p>Ridker et al reported that a CRP level of less than 2mg\/L led to a 25 percent reduction in major adverse cardiovascular events. Cardiovascular and all-cause mortality in these patients were both reduced by 31 percent. These findings clearly showcased a relationship between the degree of reduction in serum CRP levels and a decrease in cardiovascular events in patients treated with Canakinumab.<\/p>\n<p>[perfectpullquote align=&#8221;full&#8221; bordertop=&#8221;false&#8221; cite=&#8221;&#8221; link=&#8221;&#8221; color=&#8221;&#8221; class=&#8221;&#8221; size=&#8221;&#8221;]<strong>\u201cWe believe the clinical approach of targeting treatment to those who truly benefit on the basis of biological response represents a major step toward personalized medicine and rational resource utilization.\u201d<\/strong>[\/perfectpullquote]<\/p>\n<p>The authors acknowledge the limitations of the study by stating that, \u201cthe observations made here are no longer formally randomized.\u201d They remind us that their data only applies to Canakinumab and \u201cthose with elevated CRP at study entry.\u201d However, Ridker and his colleagues argue that \u201cfor individual patients where variability in drug response might exist, the availability of both a 150 mg and a 300 mg dose might broaden the clinical use of Canakinumab.\u201d<\/p>\n<p>This study helps demarcate the difference in treatment approach between patients having a residual risk of inflammation as opposed to those with residual cholesterol risk. \u201cWe believe the clinical approach of targeting treatment to those who truly benefit on the basis of biological response represents a major step toward personalized medicine and rational resource utilization.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"<p>In a recent study published in The\u00a0Lancet, it has been found that the magnitude of reduction in C Reactive Protein (CRP) levels due to treatment with Canakinumab, an interleukin 1\u03b2 targeting monoclonal antibody, may directly correlate with a decrease in major cardiovascular events in post-myocardial infarction (MI) patients, even in the absence of an alteration [&hellip;]<\/p>\n","protected":false},"author":8,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[12,8,9],"tags":[],"ppma_author":[1033],"class_list":{"0":"post-1824","1":"post","2":"type-post","3":"status-publish","4":"format-standard","6":"category-cardiovascular-prevention","7":"category-news","8":"category-prevention","9":"author-sudarshana-datta"},"authors":[{"term_id":1033,"user_id":8,"is_guest":0,"slug":"sudarshana-datta","display_name":"Sudarshana Datta, M.D.","avatar_url":"https:\/\/secure.gravatar.com\/avatar\/b79d07e34756cd9e4c6fe8c77835538219f3ec30c82a6bf8f218760a5f29c84a?s=96&r=g","0":null,"1":"","2":"","3":"","4":"","5":"","6":"","7":"","8":""}],"_links":{"self":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts\/1824","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1824"}],"version-history":[{"count":9,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts\/1824\/revisions"}],"predecessor-version":[{"id":2596,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts\/1824\/revisions\/2596"}],"wp:attachment":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1824"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1824"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1824"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fppma_author&post=1824"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}