[High-sensitivity C-reactive protein: a new risk factor of coronary disease]

CRP is an acute-phase protein released after an infection or an inflammation. Atherosclerosis is actually believed to result from the combination of lipid deposits in the arterial wall together with inflammatory cells. Numerous prospective studies have shown that the serum level of CRPhs is a strong predictor of future coronary events. The risk of such events is twice as high in patients with mean CRPhs values of 2.4 mg/l than in patients with values of 1 mg/l. Serum levels of CRPhs have been measured in 265 of our patients with normal sedimentation rate. Mean levels were 1.5 + 1.5 mg/l in men and 1.64 + 1.5 mg/l in women. Levels were higher in obese and diabetic patients. CRP levels can be slightly increased in arthritis. Serum levels double in women treated by oral estrogens after menopause. CRP should be measured at least 4 weeks after an infection such as a viral rhinitis. CRP levels decrease by 15 to 30% after treatment with glitazone (rosiglitazone) and with statins. The effect of aspirin is controversial. The magnitude of the preventive effect of aspirin and of statins on coronary risks could depend on the basal level of CRPhs. If these data are confirmed, it would be easier to select those patients who would be the most likely to benefit from the antiinflammatory treatments.