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C-reactive protein and interleukin-6 in vascular disease: culprits or passive bystanders?
Marcello Rattazzi1, Massimo Puato, Elisabetta Faggin
1Dipartimento di Medicina Clinica e Sperimentale, Università di Padova, Italy.
Insights
Inflammation plays a key role in atherosclerosis. C-reactive protein (CRP) and interleukin-6 (IL-6) are strong predictors of cardiovascular events and may actively contribute to disease development.
Area of Science:
- Cardiovascular Science
- Inflammation Biology
- Biochemistry
Background:
- Atherosclerosis is increasingly understood as a chronic inflammatory disease.
- Inflammation is critical at all stages of atherosclerosis, from initiation to complication.
- Biochemical markers of inflammation are being investigated as predictors of coronary heart disease (CHD) risk.
Purpose of the Study:
- To review the prognostic value of C-reactive protein (CRP) and interleukin-6 (IL-6) in cardiovascular disease.
- To explore the potential direct involvement of CRP and IL-6 in the process of atherogenesis.
- To assess the utility of these inflammatory markers in identifying individuals at risk for atherosclerosis.
Main Methods:
- Review of recent advances in basic science regarding inflammation and atherosclerosis.
- Analysis of large, prospective epidemiological studies on plasma levels of CRP and IL-6.
- Evaluation of evidence for the role of CRP and IL-6 in cardiovascular risk prediction and atherogenesis.
Main Results:
- Plasma levels of CRP and IL-6 are consistent, strong independent predictors of future cardiovascular events.
- These markers predict risk in both patients with existing CHD and apparently healthy individuals.
- CRP and IL-6 may serve as valuable complements to traditional risk factors for identifying at-risk subjects.
Conclusions:
- CRP and IL-6 are significant predictors of cardiovascular events, complementing traditional risk factors.
- Further research is needed to determine if CRP and IL-6 are merely markers or active contributors to atherosclerosis.
- Understanding the role of these inflammatory molecules is crucial for identifying and managing atherosclerosis risk.
Abstract:
Recent advances in basic science have shown that atherosclerosis should be considered as a chronic inflammatory process, and that a pivotal role of inflammation is evident from initiation through progression and complication of atherosclerosis. In the past few years many studies have examined the potential for biochemical markers of inflammation to act as predictors of coronary heart disease (CHD) risk in a variety of clinical settings. Several large, prospective epidemiological studies have shown consistently that C-reactive protein (CRP) and interleukin-6 (IL-6) plasma levels are strong independent predictors of risk of future cardiovascular events, both in patients with a history of CHD and in apparently healthy subjects. These molecules could be useful to complement traditional risk factors, as well as to identify new categories of subjects prone to atherosclerosis development. An intriguing question is whether these inflammatory molecules simply represent sensitive markers of systemic inflammation or if they actively contribute to atherosclerotic lesion formation and instability. In this paper we will review the evidence concerning the cardiovascular prognostic value and the potential direct involvement of CRP and IL-6 in atherogenesis.
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