C-reactive protein: a nontraditional serum marker of cardiovascular risk

Area of Science:

• Biomarkers and Cardiovascular Disease

Background:

• Cardiovascular disease (CVD) is multifactorial, with traditional risk factors like cholesterol and blood pressure being well-established.
• Emerging research highlights the critical role of inflammation in atherosclerosis, prompting investigation into inflammatory markers for enhanced CVD risk assessment.
• C-reactive protein (CRP) is implicated in atherogenesis and found in atherosclerotic lesions.

Purpose of the Study:

• To evaluate the clinical utility of high-sensitivity C-reactive protein (hsCRP) as a serum marker for cardiovascular risk assessment.
• To determine if hsCRP measurement can improve the identification of individuals at increased risk for cardiovascular events.

Main Methods:

• Review of evidence supporting the association between hsCRP levels and cardiovascular events.
• Assessment of hsCRP's predictive capacity in relation to established risk factors and clinical risk scores.
• Consideration of hsCRP assay standardization, biological stability, and the impact of interventions.

Main Results:

• High hsCRP levels are linked to a 2-3 fold increased prevalence of myocardial infarction, stroke, and peripheral vascular disease.
• Elevated hsCRP predicts incident cardiovascular events in both individuals with and without pre-existing CVD.
• The increased risk associated with high hsCRP is independent of traditional cardiovascular risk factors and augments the Framingham Risk Score.

Conclusions:

• High-sensitivity C-reactive protein (hsCRP) shows significant potential for clinical use in assessing cardiovascular risk.
• hsCRP measurement offers valuable information beyond traditional risk factors, aiding in primary and secondary CVD prevention.
• National guidelines now address the clinical utility of hsCRP, reflecting its growing importance in cardiovascular medicine.