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Hs-CRP as a biomarker for atherosclerosis progression and cardiovascular risk: a systematic review
Dalal A Al-Saedi1, Kholoud M Al-Otaibi2, Ahmed Alalhareth3
1Department of Chemistry, College of Science, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia.
Insights
High-sensitivity C-reactive protein (hs-CRP) indicates inflammation in atherosclerosis. Elevated hs-CRP levels predict cardiovascular events and disease progression, suggesting screening benefits.
Area of Science:
- Cardiovascular Medicine
- Inflammation Biomarkers
- Atherosclerosis Research
Background:
- High-sensitivity C-reactive protein (hs-CRP) is a key biomarker for inflammation in atherosclerosis.
- Elevated hs-CRP predicts adverse cardiovascular events, particularly in high-risk individuals.
Purpose of the Study:
- To systematically review the significance of hs-CRP level changes over time in atherosclerosis patients.
- To evaluate the association between hs-CRP and cardiovascular events and atherosclerosis progression.
Main Methods:
- Comprehensive literature search of major databases (PubMed, Scopus, Web of Science, Embase) up to January 2026.
- Inclusion of observational and cohort studies assessing hs-CRP in atherosclerosis.
- Quality assessment of included studies using the Newcastle-Ottawa Scale (NOS).
Main Results:
- Six studies demonstrated a link between elevated baseline hs-CRP and increased atherosclerotic progression leading to cardiovascular events.
- Variability in baseline hs-CRP levels reflected differences in inflammation severity across patient groups.
Conclusions:
- Elevated hs-CRP levels are associated with increased risk of cardiovascular events and atherosclerosis progression.
- Universal screening for hs-CRP may enhance risk assessment and reduce cardiovascular event incidence.
Background:
High-sensitivity C-reactive protein (hs-CRP) has emerged as a significant biomarker for assessing inflammatory activity in atherosclerosis, which may predict sudden death, especially in individuals with advanced atherosclerotic disease or those at high risk for acute events.
Methods:
This systematic review aimed to evaluate the significance of changes in hs-CRP levels over time in the population with atherosclerosis; the frequency of cardiovascular events, including mortality, stroke, and myocardial infarction; and changes in the progression of atherosclerosis. We conducted a comprehensive search of the PubMed, Scopus, Web of Science, and Embase databases up to January 2026 to identify observational and cohort studies evaluating high hs-CRP levels in patients with atherosclerosis, and to evaluate the quality of studies using the Newcastle-Ottawa Scale (NOS).
Results:
Our results included six studies involving baseline and follow-up hs-CRP values that showed a relationship between elevated baseline hs-CRP levels and an increased incidence of atherosclerotic progression that led to cardiovascular events. In addition, the variability in inflammation severity across different clinical events was displayed by the range of baseline hs-CRP measurements across different patient groups.
Conclusion:
Universal screening for hs-CRP may improve assessment and thereby reduce the risk of cardiovascular events.
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