C-reactive protein as a risk factor versus risk marker.
OBJECTIVE
C-reactive protein (CRP) is consistently associated with cardiovascular disease in prospective and cross-sectional clinical and epidemiological studies. Inflammation is an important mechanism in cardiovascular disease, and the plasma level of CRP is considered to reflect the inflammatory condition of the patient and/or the vessel wall. In addition, there are also a number of indications for a causal role of CRP in cardiovascular disease.


RESULTS
A number of new publications show potential causal effects of CRP on cardiovascular disease, and evidence from human-CRP transgenic animals also indicates a causal contribution of CRP to cardiovascular disease. On the other hand, a new large prospective study and an updated meta-analysis indicate that the contribution of CRP to cardiovascular disease is less impressive than reported earlier (odds ratio, 1.58; 95% confidence interval, 1.48-1.68).


CONCLUSIONS
We review here the most recent evidence on mechanisms by which CRP is involved as a causal factor in the precipitation of cardiovascular disease. Evidence for such a role is accumulating.
de Maat
Moniek Pm
MP
Department of Hematology, Erasmus University Medical Center, Rotterdam, The Netherlands. m.demaat@erasmusmc.nl
Trion
Astrid
A
D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis / Q000235:genetics / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000209:etiology*; D003324:Coronary Artery Disease / Q000097:blood / Q000209:etiology / Q000276:immunology; D003327:Coronary Disease / Q000097:blood / Q000209:etiology; D042783:Endothelial Cells / Q000737:chemistry; D006801:Humans; D009000:Monocytes / Q000276:immunology; D012307:Risk Factors
D015415:Biomarkers; D002097:C-Reactive Protein