(Circulation. 2001;103:1813.)
© 2001 American Heart Association, Inc.
Current Perspectives |
High-Sensitivity C-Reactive Protein
Potential Adjunct for Global Risk Assessment in the Primary Prevention of Cardiovascular Disease
From the Center for Cardiovascular Disease Prevention, Divisions of Cardiovascular Diseases and Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Mass.
Correspondence to Dr Paul M. Ridker, Brigham and Women’s Hospital, 75 Francis St, Boston, MA 02214. E-mail pridker{at}partners.org
Abstract—Inflammation plays a major role in atherothrombosis, and measurement of inflammatory markers such as high-sensitivity C-reactive protein (HSCRP) may provide a novel method for detecting individuals at high risk of plaque rupture. Several large-scale prospective studies demonstrate that HSCRP is a strong independent predictor of future myocardial infarction and stroke among apparently healthy men and women and that the addition of HSCRP to standard lipid screening may improve global risk prediction among those with high as well as low cholesterol levels. Because agents such as aspirin and statins seem to attenuate inflammatory risk, HSCRP may also have utility in targeting proven therapies for primary prevention. Inexpensive commercial assays for HSCRP are now available; they have shown variability and classification accuracy similar to that of cholesterol screening. Risk prediction algorithms using a simple quintile approach to HSCRP evaluation have been developed for outpatient use. Thus, although limitations inherent to inflammatory screening remain, available data suggest that HSCRP has the potential to play an important role as an adjunct for global risk assessment in the primary prevention of cardiovascular disease.
Key Words: risk factors • inflammation • cardiovascular diseases • prevention • screening
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G. Zhao, T. D. Etherton, K. R. Martin, S. G. West, P. J. Gillies, and P. M. Kris-Etherton Dietary {alpha}-Linolenic Acid Reduces Inflammatory and Lipid Cardiovascular Risk Factors in Hypercholesterolemic Men and Women J. Nutr., November 1, 2004; 134(11): 2991 - 2997. [Abstract] [Full Text] [PDF]
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S. Santos, T. W Rooke, K. R Bailey, J. P McConnell, and I. J Kullo Relation of markers of inflammation (C-reactive protein, white blood cell count, and lipoprotein-associated phospholipase A2) to the ankle brachial index Vascular Medicine, August 1, 2004; 9(3): 171 - 176. [Abstract] [PDF]
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 H Teragawa, Y Fukuda, K Matsuda, K Ueda, Y Higashi, T Oshima, M Yoshizumi, and K Chayama Relation between C reactive protein concentrations and coronary microvascular endothelial function Heart, July 1, 2004; 90(7): 750 - 754. [Abstract] [Full Text] [PDF]
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R. Rauramaa, P. Halonen, S. B. Vaisanen, T. A. Lakka, A. Schmidt-Trucksass, A. Berg, I. M. Penttila, T. Rankinen, and C. Bouchard Effects of Aerobic Physical Exercise on Inflammation and Atherosclerosis in Men: The DNASCO Study: A Six-Year Randomized, Controlled Trial Ann Intern Med, June 15, 2004; 140(12): 1007 - 1014. [Abstract] [Full Text] [PDF]
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R. Paoletti, A. M. Gotto Jr, and D. P. Hajjar Inflammation in Atherosclerosis and Implications for Therapy Circulation, June 15, 2004; 109(23_suppl_1): III-20 - III-26. [Abstract] [Full Text]
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S. Friso, D. Girelli, N. Martinelli, O. Olivieri, V. Lotto, C. Bozzini, F. Pizzolo, G. Faccini, F. Beltrame, and R. Corrocher Low plasma vitamin B-6 concentrations and modulation of coronary artery disease risk Am. J. Clinical Nutrition, June 1, 2004; 79(6): 992 - 998. [Abstract] [Full Text] [PDF]
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 R. Tauman, A. Ivanenko, L. M. O'Brien, and D. Gozal Plasma C-Reactive Protein Levels Among Children With Sleep-Disordered Breathing Pediatrics, June 1, 2004; 113(6): e564 - e569. [Abstract] [Full Text]
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R. D. Brook, B. Franklin, W. Cascio, Y. Hong, G. Howard, M. Lipsett, R. Luepker, M. Mittleman, J. Samet, S. C. Smith Jr, et al. Air Pollution and Cardiovascular Disease: A Statement for Healthcare Professionals From the Expert Panel on Population and Prevention Science of the American Heart Association Circulation, June 1, 2004; 109(21): 2655 - 2671. [Abstract] [Full Text] [PDF]
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E. T.H. Yeh CRP as a Mediator of Disease Circulation, June 1, 2004; 109(21_suppl_1): II-11 - II-14. [Abstract] [Full Text] [PDF]
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A. S.M. Shamsuzzaman, M. Winnicki, R. Wolk, A. Svatikova, B. G. Phillips, D. E. Davison, P. B. Berger, and V. K. Somers Independent Association Between Plasma Leptin and C-Reactive Protein in Healthy Humans Circulation, May 11, 2004; 109(18): 2181 - 2185. [Abstract] [Full Text] [PDF]
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S. Verma, M. A. Kuliszewski, S.-H. Li, P. E. Szmitko, L. Zucco, C.-H. Wang, M. V. Badiwala, D. A.G. Mickle, R. D. Weisel, P. W.M. Fedak, et al. C-Reactive Protein Attenuates Endothelial Progenitor Cell Survival, Differentiation, and Function: Further Evidence of a Mechanistic Link Between C-Reactive Protein and Cardiovascular Disease Circulation, May 4, 2004; 109(17): 2058 - 2067. [Abstract] [Full Text] [PDF]
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S. Verma, P. E. Szmitko, and E. T.H. Yeh C-Reactive Protein: Structure Affects Function Circulation, April 27, 2004; 109(16): 1914 - 1917. [Full Text] [PDF]
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M. Riediker, W. E. Cascio, T. R. Griggs, M. C. Herbst, P. A. Bromberg, L. Neas, R. W. Williams, and R. B. Devlin Particulate Matter Exposure in Cars Is Associated with Cardiovascular Effects in Healthy Young Men Am. J. Respir. Crit. Care Med., April 15, 2004; 169(8): 934 - 940. [Abstract] [Full Text] [PDF]
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B. J Nicklas, W. Ambrosius, S. P Messier, G. D Miller, B. W. Penninx, R. F Loeser, S. Palla, E. Bleecker, and M. Pahor Diet-induced weight loss, exercise, and chronic inflammation in older, obese adults: a randomized controlled clinical trial Am. J. Clinical Nutrition, April 1, 2004; 79(4): 544 - 551. [Abstract] [Full Text] [PDF]
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T. You, D. M. Berman, A. S. Ryan, and B. J. Nicklas Effects of Hypocaloric Diet and Exercise Training on Inflammation and Adipocyte Lipolysis in Obese Postmenopausal Women J. Clin. Endocrinol. Metab., April 1, 2004; 89(4): 1739 - 1746. [Abstract] [Full Text] [PDF]
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S. E. Humphries, P. M. Ridker, and P. J. Talmud Genetic Testing for Cardiovascular Disease Susceptibility: A Useful Clinical Management Tool or Possible Misinformation? Arterioscler Thromb Vasc Biol, April 1, 2004; 24(4): 628 - 636. [Abstract] [Full Text] [PDF]
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D. L. Brown, K. K. Desai, B. A. Vakili, C. Nouneh, H.-M. Lee, and L. M. Golub Clinical and Biochemical Results of the Metalloproteinase Inhibition with Subantimicrobial Doses of Doxycycline to Prevent Acute Coronary Syndromes (MIDAS) Pilot Trial Arterioscler Thromb Vasc Biol, April 1, 2004; 24(4): 733 - 738. [Abstract] [Full Text] [PDF]
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R. V. Milani, C. J. Lavie, and M. R. Mehra Reduction in C-reactive protein through cardiac rehabilitation and exercise training J. Am. Coll. Cardiol., March 17, 2004; 43(6): 1056 - 1061. [Abstract] [Full Text] [PDF]
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M. Haim, V. Boyko, U. Goldbourt, A. Battler, and S. Behar Predictive Value of Elevated White Blood Cell Count in Patients With Preexisting Coronary Heart Disease: The Bezafibrate Infarction Prevention Study Arch Intern Med, February 23, 2004; 164(4): 433 - 439. [Abstract] [Full Text] [PDF]
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