And Paul M Ridker MD MPH

Contents

Novel Risk Factors and Cardiovascular Risk Prediction Pathophysiology of CRP hsCRP and Cardiovascular Risk:

Epidemiological and Clinical Data Practical Considerations Therapeutic Interventions Clinical Recommendations References

Summary

High-sensitivity C-reactive protein (hsCRP) is a marker of inflammation that predicts incident myocardial infarction, stroke, peripheral arterial disease, and sudden cardiac death among healthy persons without a history of cardiovascular disease, as well as recurrent events and death in patients with acute or stable coronary syndromes. hsCRP adds prognostic value at all levels of low-density lipoprotein cholesterol, Framingham coronary risk score, severity of the metabolic syndrome, and blood pressure, and in those with and without subclinical atherosclerosis. Among apparently healthy men and women, hsCRP levels of less than 1, 1 to 3, and greater than 3 mg/L distinguish those at low, moderate, and high risk for future cardiovascular disease, respectively. In clinical settings, hsCRP should be used in conjunction with lipid evaluation as part of global risk assessment. Improved knowledge of cardiovascular risk should lead to better compliance with lifestyle and pharmacological interventions designed to prevent future cardiovascular events.

Key Words: C-reactive protein; cardiovascular disease; clinical medicine; epidemiology; inflammation; risk assessment.

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