FORT WORTH, Texas— Relying on cholesterol levels alone to pinpoint who’s at risk for heart disease may not be enough, according to a paper to be published in this week’s New England Journal of Medicine.

Study authors, including researchers at the University of North Texas Health Science Center, measured C-reactive protein levels, along with cholesterol levels, to gain insight into who can benefit from preventive drug therapy. The study showed that statin drug therapy may help prevent coronary events in people who have elevated C-reactive protein values but whose baseline levels of LDL cholesterol are considered normal. If confirmed in additional studies, the results may provide persuasive evidence for measuring both C-reactive protein and blood lipids in healthy adults.

Results are based on further analysis of the Air Force/Texas Coronary Atherosclerosis Prevention Study (AFCAPS/TexCAPS), a primary prevention trial of Merck and Co.’s cholesterol-lowering drug Mevacor“ (lovastatin). Researchers studied whether study participants with elevated C-reactive protein levels but no hyperlipidema benefited from taking the drug.

The AFCAPS/TexCAPS was conducted between 1990 and 1998 at the UNT Health Science Center in Fort Worth and the Wilford Hall Medical Center at Lackland Air Force Base in San Antonio.

Michael Clearfield, D.O., chief of internal medicine at the UNT Health Science Center, served as principal investigator for the TexCAPS study. Stephen Weis, D.O., professor of internal medicine, was a co-investigator for the study.

"Half the people who develop heart disease have a cholesterol level that is considered to be normal and many do not have other identified risk factors," said Dr. Clearfield. "We now have a way to better identify apparently healthy people who can benefit from preventive treatment."

AFCAPS/TexCAPS included 6,605 participants whose average cholesterol levels were 221 at baseline and had average HDL cholesterol levels of 37. Between 1990 and 1998, a total of 2,868 participants took part in the study through the TexCAPS clinics located on the health science center’s campus in Fort Worth’s cultural district. The remaining participants were studied in San Antonio.

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