Fibrinogen, C-Reactive Protein, and Coronary Artery Disease

Dear Dr. Dean,

I read Dr. Rosick’s very interesting article on coronary artery calcium (CAC) in the November, 2004 issue of Life Enhancement magazine.

I have coronary artery disease (CAD) (no MI’s — yet) but have had two stents and will either have another in the years to come or suffer from a heart attack. I caught each blockage at 95% and went to the E.R. Symptoms were extreme fatigue and slight chest pains for 5 weeks, each time.

I am 5’10, weigh 160 lbs, and am active. I am 69 years old. My first stent was in 2006, and my second in 2013 — both performed in August. My HDL and LDL are always normal, as are blood pressure and EKG. If I hadn't had two cardiologists who treated by symptoms alone, I am sure I would have suffered a heart attack.

I believe I have the CAC discussed in the article. I would like to try Chelation but would need Medicare to pay for it. In the 50’s, 60’s and 70’s, I worked with DDT and chlordane on a daily basis. I would return home from work saturated. I did not use any type of gear. I believe that being exposed to the Atomic Bomb fall out in the 50’s and the work with the DDT and Chlordane might show high levels of metal toxicity in my blood.

If I do suffer from heavy metal toxicity, I believe Medicare will pay for me to have the procedure. I have 100% coverage and can go to any doctor with my Medicare and Medicare supplement plan F. Would the Chelation procedure to treat metal toxicity be the same treatment that would be used for cardiovascular calcium (CVC)?

Currently, I am in Corpus Christi, Texas and in April will be going to Colorado Springs, CO. Do you know of any reputable doctors that I could contact to be tested for metal toxicity and provide treatment that would benefit both conditions in either area?

I appreciate your time. My doctor told me that I will most likely die from a heart attack or a stroke due to my CAD. Since I have recognized my symptoms, I am trying to ward of the inevitable … .at least as prognosticated by my physician.

Best Regards,
Richard, Colorado Springs, CO

Figure 1. Incidence of coronary events during two years of follow-up, according to concentrations of fibrinogen, C-Reactive Protein, and total cholesterol. Panel A shows the risk of heart attack according to fibrinogen and total cholesterol. Panel B shows the risk according to Fibrinogen and C-Reactive Protein combined, as compared to total cholesterol.3 It is clear that elevated fibrinogen greatly increases the risk associated with these other two risk factors.

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Dear Richard,

As you noted, having normal cholesterol, LDL, HDL, and tri­glcerides, is no guarantee that you are “immune” from cardiovascular problems. What are your fibrinogen, high-sensitivity C-Reactive Protein (HS-CRP), and myeloperoxidase (MPO) levels? These are all independent cardiovascular risk factors that can be dramatically elevated in those with “normal” lipids1,2 (Fig. 1).

Unfortunately, since there are no drugs to lower fibrinogen, physicians rarely investigate this very significant risk factor.

Likewise, myeloperoxidase is a proinflammatory enzyme that is abundant in ruptured plaque and can be measured in peripheral blood. MPO is secreted during inflammatory conditions, and consumes endothelial-derived nitric oxide (NO), thereby reducing NO bioavailability and impairing its vasodilating and anti-inflammatory properties. Higher serum levels of MPO are frequently elevated in peripheral artery disease and with increased risk of adverse cardiovascular events3,4 (Fig. 2).

Figure 2. MPO and CRP predict cardiovascular mortality in patients with angiographic evidence of coronary artery disease.2

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If you do, in fact, have elevated coronary artery calcium, I agree that chelation therapy — oral and / or IV — is the preventive treatment of choice. If your goal is the removal of the calcium, the traditional Sodium EDTA is the way to go — but if you are after other heavy metals (lead, cadmium, aluminum, beryllium, gadolinium — and mercury, to some degree) you will get better results with Calcium EDTA. I would not hold your breath, however, waiting for Medicare to cover your treatments. Rarely does Medicare pay for my patients’ treatments — even when documented to have heavy metal toxicity.

I would start IMMEDIATELY with a program of daily oral EDTA — at least one gram (1,000 mg) per day. Garry Gordon, MD, has reportedly consumed as much as 6 grams EDTA per day. EDTA will not only remove calcium and the other heavy metals (as well as essential minerals, so it’s important to take a daily broad spectrum mineral supplement — especially magnesium), but it is also a very effective anti-coagulant, helping to prevent blood clots leading to heart attacks and strokes.

Figure 3. Effects of turmeric on plasma fibrinogen levels in eight subjects with elevated fibrinogen after 15 days treatment.7

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You should be able to find a physician who will administer IV EDTA by contacting the medical associations, which support this treatment (American College for Advancement in Medicine [ACAM] and the International College of Integrative Medicine [ICIM]).

To lower inflammatory factors (HS-CRP, MPO, and fibrinogen), I suggest high-dose Turmeric5 (Fig. 3) and Boswella extract, as well as substances to promote Nitric Oxide4 (Arginine, Citrulline, and beet root powder). Also, anti-inflammatory enzymes like serrapeptase, and papaine may also help.

Ward Dean, MD


  1. Thomson, S.G., Kienast, J., Pyke, S.D.M., Haverkate, F., Van de Loo, J.C.W. Hemostatic factors and the risk of myocardial infarction or sudden death in patients with angina pectoris. N Engl J Med. 1995;332:635 – 641.
  2. Heslop CL, et al. Myeloperoxidase and C-reactive protein have combined utility for long term prediction of cardiovascular mortality after coronary angiography. J Am Coll Cardiol. 2010;55:1102 – 9.
  3. Loria V, Dato I, Graziani F, Biasucci LM. Myeloperoxidase: A New Biomarker of Inflammation in Ischemic Heart Disease and Acute Coronary Syndromes. Mediators Inflamm. 2008;2008:135625. doi: 10.1155 / 2008 / 135625.
  4. Ali Z, Sarcia P, Mosley TH, Jr, Kullo IJ. Association of Serum Myeloperoxidase with Peripheral Arterial Disease. Vasc Med. Aug 2009;14(3):215 – 20.
  5. Ramirez-Boscá A, Soler A, Carrión-Gutiérrez MA, Pamies Mira D, Pardo Zapata J, Diaz-Alperi J, Bernd A, Quintanilla Almagro E, Miquel J. An hydroalcoholic extract of Curcuma longa lowers the abnormally high values of human-plasma fibrinogen. Mech Aging Dev. 2000;114:207 – 20.

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