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Revisiting C-reactive Protein, Interleukin 6 and Fibrinogen: Markers or Mediators of Cardiovascular Disease?

Angela Papa1, Silvana Balzan2, Valter Lubrano1

  • 1Fondazione CNR/Regione Toscana G. Monasterio, Via Moruzzi 1, Pisa 56124, Italy.

Theoretical Biology Forum
|February 19, 2026
PubMed

Insights

C-reactive protein, interleukin-6, and fibrinogen are key inflammatory biomarkers linked to cardiovascular disease. Emerging research suggests these markers actively drive disease development, not just indicate inflammation, offering potential therapeutic targets.

Area of Science:

  • Cardiovascular Medicine
  • Inflammation Research
  • Biomarker Analysis

Background:

  • Atherosclerosis and diabetes are recognized as inflammatory conditions contributing to cardiovascular disease (CVD).
  • Established inflammatory biomarkers include C-reactive protein (CRP), interleukin-6 (IL-6), and fibrinogen, used in managing atherosclerosis, diabetes, and heart failure.
  • Emerging evidence indicates these biomarkers may actively mediate CVD pathogenesis, beyond simply reflecting inflammation.

Purpose of the Study:

  • To investigate the interplay between key inflammatory biomarkers (CRP, IL-6, fibrinogen) and cardiovascular risk factors.
  • To determine if CRP, IL-6, and fibrinogen are passive indicators or active contributors to cardiovascular disease pathogenesis.
  • To analyze the associations of these biomarkers with dyslipidemia, hyperglycemia, insulin resistance, and NT-proBNP levels.

Main Methods:

  • Review of existing literature analyzing the links between CRP, IL-6, fibrinogen, and cardiovascular risk factors.
  • Examination of the direct mechanisms by which CRP influences atherosclerosis (LDL transcytosis, LOX-1 expression).
  • Analysis of IL-6's role in hepatic LDL receptor transcription and its correlation with endothelial dysfunction and NT-proBNP.
  • Assessment of fibrinogen's association with atherogenic lipoprotein profiles, insulin resistance, and fibrinolysis in diabetic patients.

Main Results:

  • C-reactive protein directly promotes atherosclerosis and predicts mortality in type 2 diabetes and adverse cardiac events post-MI.
  • Interleukin-6 is linked to endothelial dysfunction, higher NT-proBNP levels, and insulin resistance.
  • Fibrinogen is associated with atherogenic lipoproteins, impaired fibrinolysis in diabetics, and elevated NT-proBNP in heart failure via the fibrinogen-to-albumin ratio.

Conclusions:

  • CRP, IL-6, and fibrinogen may act as active drivers in cardiovascular disease development.
  • These inflammatory biomarkers demonstrate significant associations with key cardiovascular risk factors.
  • CRP, IL-6, and fibrinogen represent promising therapeutic targets for cardiovascular diseases.

Keywords:
C-reactive ProteinFibrinogenHDLInsulin ResistanceInterleukin-6LDLNT-pro-BNP

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