C-Reactive Protein as a Novel Risk Factor for Cardiovascular Disease: Is It Ready for Prime Time?

摘要

C-reactive protein (CRP) is a novel, strong independent risk factor for cardiovascular disease (CVD) that appears to have significant clinical utility. Early findings from the Honolulu Heart Program and several other large, prospective, epidemiologic studies support the use of CRP in populationwide screening for CVD; however, at present there are no interventional data to show that lowering CRP lowers risk for CVD. A recent American Heart Association/Centers for Disease Control and Prevention clinical practice statement specifically emphasizes the lack of prospective, interventional trials that show that lowering CRP lowers CVD risk-Therefore, selective application of high-sensitivity CRP screening in primary prevention is recommended over populationwide screening. CRP has less clinical utility in secondary prevention because this currently necessitates intensive risk-factor reduction, which usually lowers CRP as well. Priority should be given to the treatment of established modifiable risk factors for CVD until the results of further trials provide more definitive evidence for the role of CRP in primary prevention.