Department of Medicine

Case Western Reserve University School of Medicine & UH Case Medical Center

Much-needed complement to cholesterol testing

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For patients outside the highest and lowest traditional risk factor categories, based on factors like high cholesterol, smoking, diabetes, hypertension and family history of heart disease, MRP-8/14 could become a prominent diagnostic tool. “We are attempting to determine whether the use of MRP-8/14 should sway us toward more aggressive preventive therapies,” says Carl Orringer, MD, the Harrington Heart & Vascular Institute Chair in Preventive Cardiovascular Medicine at the School of Medicine.

Currently, a “high-sensitivity C-reactive protein” (hs-CRP) assay is sometimes used in conjunction with cholesterol tests to assess heart disease risk. Like hs-CRP, MRP-8/14 represents a different biological process than cholesterol and is likely to serve as a complement to, not a substitute for, cholesterol screening. Of cholesterol testing’s shortcomings, Dr. Orringer says, “Relying on cholesterol alone is ignoring the inflammation that lights the fuse that sets off the explosion that is the heart ttack.”

Dr. Orringer, who developed an innovative heart attack risk assessment program that uses CT scans to see whether a person has hardening of the arteries, believes that MRP-8/14 may come to be incorporated to aid in risk estimation.

“A person’s heart attack risk is related to how much calcium is in the arteries—the more calcium, the greater the risk,” Dr. Orringer explains. “Those with calcium in their arteries indicating atherosclerosis might be really good candidates for MRP-8/14 evaluation to see who is at the highest risk.”

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