C-reactive protein, statins and the risk of vascular events: a better understanding

The association between C-reactive protein (CRP) and cardiovascular disease has been under investigation for more than sixty years. Lately, findings from the Justification for the Use of Statins in Prevention: an Intervention Trial Evaluating Rosuvastatin (JUPITER) trial opened a new frontier: that of prescribing statins for vascular events risk reduction based upon the baseline CRP levels in otherwise healthy adults. Although the results from the JUPITER were impressive, ambiguities and arguments about this association have remained. Moreover, the results of a report by Heart Protection Study investigators have added to the complexities of the correlation between CRP levels and the risk of vascular events. In this review, a summary of the structural and functional properties of CRP and findings from various randomized controlled trials and observational studies is provided. This may lead to a better understanding of the intricate link between CRP levels and the risk of ensuing vascular events and the intermediary role of statins in reducing the vascular risk beyond what is justified by the lipocentric theory, by reducing the levels of CRP.