C-reactive protein and cardiovascular disease: new insights from an old molecule
1Centre for Amyloidosis and Acute Phase Proteins, Department of Medicine, Royal Free and University College Medical School, Royal Free Campus, London, UK. g.hirschfield@rfc.ucl.ac.uk
Insights
C-reactive protein (CRP) is a sensitive marker for disease and inflammation. Elevated CRP levels predict cardiovascular events and may play a role in disease development, suggesting it as a potential therapeutic target.
Area of Science:
- Biochemistry
- Immunology
- Cardiology
Background:
- C-reactive protein (CRP) is a key acute-phase protein.
- Inflammation significantly influences CRP synthesis and is central to atherothrombotic cardiovascular disease.
- Elevated CRP is linked to adverse outcomes in acute coronary syndromes and future cardiovascular events.
Purpose of the Study:
- To review the biological properties of CRP.
- To examine the association between CRP and cardiovascular disease.
- To explore CRP as a potential therapeutic target for cardiovascular disease.
Main Methods:
- Literature review of biological properties of CRP.
- Analysis of epidemiological studies on CRP and cardiovascular disease.
- Evaluation of CRP's role in atherothrombosis pathogenesis.
Main Results:
- CRP is a sensitive systemic marker for disease monitoring and diagnosis.
- Raised CRP levels strongly predict cardiovascular events, including acute coronary syndromes.
- CRP is present in atherosclerotic plaques and myocardial infarction lesions, binds to lipoproteins, and activates complement, indicating a potential role in disease pathogenesis.
Conclusions:
- CRP's association with cardiovascular disease is well-established.
- CRP may actively contribute to the development and complications of cardiovascular disease.
- CRP represents a promising novel therapeutic target for cardiovascular conditions.
Abstract:
The classical acute-phase protein, C-reactive protein (CRP), is an exquisitely sensitive systemic marker of disease with broad clinical utility for monitoring and differential diagnosis. Inflammation, the key regulator of CRP synthesis, plays a pivotal role in atherothrombotic cardiovascular disease. There is a powerful predictive association between raised serum CRP values and the outcome of acute coronary syndromes, and, remarkably, between even modestly increased CRP production and future atherothrombotic events in otherwise healthy individuals. Baseline CRP values also reflect metabolic states associated with atherothrombotic events. The presence of CRP within most atherosclerotic plaques and all acute myocardial infarction lesions, coupled with binding of CRP to lipoproteins and its capacity for pro-inflammatory complement activation, suggests that CRP may contribute to the pathogenesis and complications of cardiovascular disease. We review the biological properties of CRP, the association between CRP and cardiovascular disease, and the possibility that CRP may be a novel therapeutic target.
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