C-reactive protein and prognosis in diabetes: getting to the heart of the matter. Diabetes 2009;58:798–799

C-reactive protein (CRP) is a liver-derived proteinwhose concentration increases manyfold duringinflammation or infection, making it a usefuldiagnostic and treatment measure in diseases such as rheumatoid arthritis. However, in the last decade, CRP has garnered interest as a biomarker of vascular risk that has stimulated more studies than perhaps any other “novel ” biomarker. In these studies, the much lower CRP values seen in healthy individuals free from overt infection or inflammation, detected by a new generation of sensitive assays, have been associated in study after study with the risk of a first cardiovascular event (rev. in 1). Yet, despite the consistency of this association, whether CRP is caus-ally involved in atherogenesis or whether it helps in prediction of cardiovascular disease (CVD) events remains intensely controversial (2,3). In light of this controversy, studies examining the asso-ciation of CRP with vascular outcome and mortality i