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C-reactive protein and cardiovascular disease: weighing the evidence

Gordon D O Lowe1, Mark B Pepys

  • 1Centre for Amyloidosis and Acute Phase Proteins, Department of Medicine, University College London, Rowland Hill Street, London NW3 2PF, United Kingdom.

Current Atherosclerosis Reports
|August 12, 2006
PubMed

Insights

C-reactive protein (CRP) is likely not a useful predictor for cardiovascular events. Recent evidence suggests its association is weaker than believed and potentially due to other risk factors, not CRP itself.

Area of Science:

  • Biochemistry
  • Cardiology
  • Genetics

Background:

  • C-reactive protein (CRP) has been considered a significant predictor of cardiovascular events and metabolic syndrome.
  • It was also thought to play a causal role in atherothrombosis.

Purpose of the Study:

  • To re-evaluate the predictive value of CRP for cardiovascular events and metabolic syndrome.
  • To investigate the causal role of CRP in atherothrombosis.

Main Methods:

  • Analysis of recent evidence regarding CRP's association with cardiovascular events.
  • Examination of the relationship between CRP gene polymorphisms and cardiovascular outcomes.
  • Review of in vitro studies on CRP's effects, considering potential contaminants.

Main Results:

  • The association between CRP and cardiovascular events appears weaker than previously assumed.
  • This association may be confounded by established cardiovascular risk factors.
  • Noncoding CRP gene polymorphisms are not associated with coronary events or metabolic syndrome.
  • Many claimed proatherothrombotic effects of CRP in vitro were due to contaminants in commercial preparations.

Conclusions:

  • CRP is likely not a clinically useful predictor of cardiovascular events or metabolic syndrome.
  • The evidence does not support a causal role for CRP in atherothrombosis.
  • Future trials of CRP inhibitors may clarify CRP's role in cardiovascular disease pathogenesis.

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