2001/03/01 by Nader Rifai, Paul M. Ridker, Paul M Ridker · 522 citations
Medicine · #Acute coronary syndrome #Adipokines, Inflammation, and Metabolic Diseases #Aspirin #C-reactive protein #Cardiology #Cardiovascular Disease and Adiposity #Disease #Epidemiology #Framingham Risk Score #Inflammation #Inflammatory Biomarkers in Disease Prognosis #Internal medicine #Medicine #Myocardial infarction #Population #Prospective cohort study
paper · pdf · doi:10.1093/clinchem/47.3.403
published in Clinical Chemistry 47(3), 403-411 (American Association for Clinical Chemistry)
openalex publication_date 2001/03/01 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/30
BACKGROUND: Coronary heart disease remains the leading cause of morbidity and mortality in the industrialized world. Clinical and laboratory studies have shown that inflammation plays a major role in the initiation, progression, and destabilization of atheromas. C-Reactive protein (CRP), an acute phase reactant that reflects low-grade systemic inflammation, has been studied in a variety of cardiovascular diseases. APPROACH: Findings from prospective clinical trials were examined to determine the prognostic utility of CRP in acute coronary syndromes, and observations from epidemiological studies were reviewed to determine the ability of CRP to predict future first coronary events. The analytical considerations of CRP measurement in these clinical applications were also examined. CONTENT: In patients with established coronary disease, CRP has been shown to predict adverse clinical events. In addition, prospective studies have consistently shown that CRP is a strong predictor of future coronary events in apparently healthy men and women. The relative risk associated with CRP is independent of other cardiovascular disease risk factors. High-sensitivity CRP (hs-CRP) assays are needed for risk assessment of cardiovascular disease. Such assays are currently available but may require further standardization because patients' results will be interpreted using population-based cutpoints. Preventive therapies to attenuate coronary risk in individuals with increased hs-CRP concentrations include aspirin and statin-type drugs. SUMMARY: hs-CRP has prognostic utility in patients with acute coronary syndromes and is a strong independent predictor of future coronary events in apparently healthy subjects.