High cholesterol isn't the only risk factor - Coronary Disease - medical research - Brief Article

USA Today (Society for the Advancement of Education), Oct, 2002

You probably are aware that high cholesterol puts you at risk for coronary artery disease (CAD), but did you know that an estimated 50% of people who suffer heart attacks have normal cholesterol levels? According to the Mayo Clinic Women's HeathSource, researchers have been looking for other indicators--beyond high blood pressure, smoking, and diabetes--that might put people at risk for CAD. Chief among them are C-reactive protein (CRP), homocysteine, fibrinogen, and lipoprotein(a), also known as Lp(a).

CRP is manufactured when body tissue is injured or inflamed. Researchers believe that elevated CRP can be the result of atherosclerosis--an inflammatory-like process in the arteries. Atherosclerosis is the most common form of CAD. Homocysteine is an amino acid that, in large amounts, can damage blood vessels in the heart and brain. High levels of homocysteine can run in families, and regular folic acid intake may help keep those levels normal. Fibrinogen is a blood-clotting protein manufactured by the body that can indicate inflammation and an increased likelihood of blood clots. Raised levels of fibrinogen are associated with an increased risk of CAD, but the exact reason is unknown. Fibrinogen also is higher in smokers. Lp(a) is a cholesterol-carrying molecule that also carries a protein which might inhibit the body's ability to dissolve blood clots. This, in turn, may increase the risk of heart attacks.

At present, there isn't enough information about these emerging risk factors to make regular screening useful. However, if you have a family history of heart disease, they may play a more-important role in your health.