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Similar results were found using the total cholesterol:HDL-C ratio in AFCAPS/TexCAPS patients. Among individuals with an above-median total cholesterol:HDL-C ratio, the NNT with lovastatin to prevent 1 clinical event was within treatment guidelines regardless of the CRP level. Among patients with below-median total cholesterol:HDL-C ratios, the NNT in those with an elevated CRP was also quite comparable, whereas in those with a low level of CRP, the absolute event rate was low and the efficacy of lovastatin was minimal, with the result that the NNT was very large. On the basis of these data, our research group is currently initiating a randomized clinical trial specifically addressing the efficacy of statin therapy among individuals with low levels of cholesterol but elevated levels of CRP. 

Ridker PM, Rifai N, Clearfield M, Downs JR, Weis SE, Miles JS, Gotto AM Jr, for the Air Force/Texas Coronary Atherosclerosis Prevention Study Investigators. Measurement of C-reactive protein for the targeting of statin therapy in the primary prevention of acute coronary events. N Engl J Med 2001;344:1959-1965.
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