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Correspondence
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Volume 348:1059-1061 March 13, 2003 Number 11
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C-Reactive Protein in the Prediction of Cardiovascular Events

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 by Ridker, P. M.
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To the Editor: In the analysis by Ridker et al. (Nov. 14 issue),1 several methodologic issues merit attention before claims of superiority for C-reactive protein in the prediction of cardiovascular risk can be substantiated. First, the authors did not adjust for body-mass index, which, given its strong correlation with C-reactive protein, is a major potential confounder of the relation between C-reactive protein and cardiovascular outcomes. Second, because high levels of low-density lipoprotein (LDL) cholesterol were undoubtedly treated during follow-up, the relation between LDL cholesterol and cardiovascular events was attenuated; similar treatment of high levels of C-reactive protein did not occur.

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