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Role of C-reactive protein in acute myocardial infarction and stroke: possible therapeutic approaches
Paolo Calabrò1, Enrica Golia, Edward T H Yeh
1Division of Cardiology, Department of Cardiothoracic Sciences, Second University of Naples, Monaldi Hospital, Via L. Bianchi 8013- Naples, Italy. paolo.calabro@unina2.it
Insights
C-reactive protein (CRP) shows potential as a novel risk marker for myocardial infarction (MI) and stroke. Lowering CRP levels through therapies like statins may improve patient outcomes, suggesting a role in guiding treatment.
Area of Science:
- Cardiovascular Medicine
- Biomarkers
- Atherosclerosis Research
Background:
- Myocardial infarction (MI) and stroke are leading causes of death and disability in Western countries.
- Identifying novel risk factors is crucial for better patient stratification and targeted interventions.
- C-reactive protein (CRP) is a well-studied inflammatory marker implicated in atherogenesis.
Purpose of the Study:
- To explore the role of C-reactive protein (CRP) as a non-traditional risk factor for cardiovascular events.
- To assess the predictive value of CRP for initial MI and stroke, and outcomes in acute settings.
- To evaluate the potential of CRP to guide therapeutic strategies in acute coronary syndromes (ACS) and stroke.
Main Methods:
- Review of existing studies investigating the association between CRP levels and cardiovascular events.
- Analysis of CRP's role in different stages of atherogenesis and its correlation with clinical outcomes.
- Examination of the impact of CRP-lowering therapies, such as statins, on patient prognosis.
Main Results:
- CRP is linked to various stages of atherosclerosis, from initiation to clinical events like ACS.
- Studies indicate CRP can predict first-time MI and stroke in healthy individuals and prognosis in acute cases.
- Therapeutic interventions reducing CRP levels, notably statins, are associated with improved patient outcomes.
Conclusions:
- C-reactive protein (CRP) serves as a significant predictor for cardiovascular events like MI and stroke.
- CRP levels may offer valuable insights for risk stratification and guiding treatment decisions in patients with ACS and stroke.
- Further large-scale randomized controlled trials are warranted to confirm CRP's role in treatment guidance.
Abstract:
Myocardial infarction (MI) and stroke are relevant clinical issues in Western Countries for morbidity and mortality. In the last decades, great interest has been paid to the identification of non-traditional risk factors for a better stratification of patients and to recognize those at higher risk, who might particularly benefit from a more aggressive approach. In this field, C-reactive protein (CRP) is the most extensively studied novel marker, since it seems related to several stages of atherogenesis, from its beginning to clinical events (i.e. acute coronary syndromes - ACS). Among its possible pathogenetic role both in coronary artery disease (CAD) and ischemic stroke, several studies have shown that CRP could be used to predict first ever MI and stroke in healthy subjects, as well as outcome in acute settings. Moreover, a decrease of CRP levels can be achieved by several therapies, first of all statins, and this seems to be associated with a better outcome. Then a possible role for CRP to guide treatment of patient with ACS and stroke has been claimed and need to be specifically addressed by large randomized controlled trials.
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