[Inflammation and C-reactive protein in cardiovascular disease].
BACKGROUND
This article reviews the role of inflammation in development of atherosclerosis and associated complications and discusses use of the inflammatory marker - high-sensitivity C-reactive protein (hs-CRP) - in risk stratification.


METHODS
The article is based on selected publications retrieved from a non-systematic search of PubMed and the authors' experience within the field.


RESULTS
Both chronic inflammatory disease and acute infections are associated with an increased risk of cardiovascular events. Influenza vaccination reduces the risk of coronary ischaemic events in patients with coronary artery disease, but the effect on cardiovascular mortality is not documented. Hs-CRP is an independent predictor of cardiovascular events in populations with and without established cardiovascular disease. Treatment with Rosuvastatin led to decreased hs-CRP-levels and a reduced risk for cardiovascular events in subjects without known cardiovascular disease, with normal serum cholesterol and hs-CRP-levels above 2 mg/l.


CONCLUSIONS
Individuals with chronic inflammatory disease and those with high risk and acute infection are at risk for cardiovascular events and should be evaluated for primary prevention. In patient groups at moderate risk for cardiovascular disease, hs-CRP can be a valuable supplement to established factors for risk stratification. Despite numerous studies confirming hs-CRP's role as an independent risk marker, hs-CRP has not found its place in international guidelines. This should be reconsidered on the background of new study results.
Munk
Peter Scott
PS
smpe@sus.no
Larsen
Alf Inge
AI
D001168:Arthritis / Q000097:blood / Q000150:complications; D050197:Atherosclerosis / Q000097:blood / Q000209:etiology / Q000517:prevention & control; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis*; D002318:Cardiovascular Diseases / Q000097:blood* / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects; D007249:Inflammation / Q000097:blood* / Q000150:complications; D007252:Influenza Vaccines / Q000008:administration & dosage; D011322:Primary Prevention; D012307:Risk Factors; D012680:Sensitivity and Specificity
D015415:Biomarkers; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007252:Influenza Vaccines; D002097:C-Reactive Protein