High-sensitivity C-reactive protein and atherosclerosis: from theory to therapy

Clin Biochem. 2000 Nov;33(8):601-10. doi: 10.1016/s0009-9120(00)00186-7.

Abstract

Atherosclerosis remains the leading cause of morbidity and mortality in Western countries. Recent evidence has demonstrated that atherosclerosis is not simply a disease of lipid deposition. Inflammation plays a major role in the initiation, progression, and destabilization of atheromas. High-sensitivity C-reactive protein (hs-CRP) is a circulating acute-phase reactant that reflects active systemic inflammation. Large prospective trials have shown hs-CRP to be a strong predictor of future cardiovascular events. Increased hs-CRP concentration is in fact associated with higher cardiovascular events in individuals with and without clinical evidence of atherosclerotic disease. The relative risk associated with hs-CRP is independent of other cardiovascular disease risk factors. Assays for hs-CRP measurement are currently available but must be standardized because patients' results will be interpreted by using population-based cutpoints. A risk-stratifying algorithm incorporating hs-CRP and total cholesterol to high-density lipoprotein cholesterol ratio has been proposed. Further research into the mechanisms and pharmacological treatment of vascular disease will provide novel management strategies in the very near future.

MeSH terms

  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Anticholesteremic Agents / therapeutic use
  • Aspirin / therapeutic use
  • Biomarkers
  • C-Reactive Protein / analysis
  • C-Reactive Protein / physiology*
  • Coronary Artery Disease / blood
  • Coronary Artery Disease / etiology*
  • Coronary Artery Disease / therapy
  • Coronary Disease / blood
  • Coronary Disease / etiology
  • Coronary Disease / therapy
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Pravastatin / therapeutic use
  • Risk Factors

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Anticholesteremic Agents
  • Biomarkers
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • C-Reactive Protein
  • Pravastatin
  • Aspirin