The role of c-reactive protein in cardiovascular disease

Kardiovaskularne bolesti vodeći su uzrok smrti u svijetu. Ateroskleroza, kao najčešći uzrok bolesti srca i krvnih žila, predmet je brojnih istraživanja u kojima je naglašena bitna uloga upale. Cilj ovog diplomskog rada je povezati razvoj ateroskleroze i upalnih zbivanja i istražiti ulogu C-reaktivnog proteina (CRP) u kardiovaskularnim bolestima te mogućnost korištenja CRP-a kao prediktora neželjenih kardiovaskularnih događaja. Ključnu ulogu u etiologiji ateroskleroze ima upala, kako u inicijaciji i progresiji tako i u aterotrombotskim komplikacijama. Postoje brojni čimbenici rizika koji mogu doprinijeti razvoju ateroskleroze. Najčešći su pušenje, dislipidemija, arterijska hipertenzija, šećerna bolest, muški spol. Navedeni čimbenici koriste se i za procjenu rizika za razvoj neželjenih kardiovaskularnih događaja. Međutim, javila se potreba za novijim čimbenicima rizika koji bi bili bolji i precizniji prediktori neželjenih kardiovaskularnih događaja. Jedan od tih potencijalnih čimbenika je i CRP. Brojne studije pokazuju pozitivnu povezanost povišenih vrijednosti CRP-a i neželjenih kardiovaskularnih događaja. Istraživanja su dokazala da su povišene vrijednosti CRP-a povezane s povećanim rizikom za razvoj koronarne bolesti srca u oba spola i budućih komplikacija ili novih KV događaja. CRP može biti povišen u svim kliničkim oblicima koronarne bolesti srca. Povišene vrijednosti CRP-a nalazimo i u ishemijskom moždanom udaru i neka istraživanja su pokazala da je povećana razina CRP dobar prediktor cerebrovaskularnog događaja. Međutim, postoji određeni broj istraživanja koja ne potvrđuju ulogu CRP-a kao nezavisnog prediktora cerebrovaskularnih događaja. Uloga CRP-a u ishemijskom moždanom udaru još uvijek nije u potpunosti razjašnjena. Što se tiče periferne arterijske bolesti pretpostavljeno je da CRP može biti nezavisni rizični čimbenik za razvoj PAD, ali i prediktor ishoda bolesti,odnosno mogućih komplikacija uključujući i kardiovaskularnu smrtnost.Cardiovascular disease is the leading cause of death for both men and women. Atherosclerosis is by far the most frequent underlying cause of the majority of cardiovascular diseases. Recent concepts point to the central role of the inflammatory process. The purpose of this study is to investigate the association between atherosclerosis and inflammation, blood levels of C-reactive protein and cardiovascular disease and utility of inflammatory markers in predicting incident CVD. Accumulating evidence supports inflammation as a key pathogenetic mechanism in the development, progression and, ultimately, the thrombotic complications of atherosclerosis. Many factors are involved in the genesis of atherosclerosis, a well-known different risk factors that could contribute to development of the atherosclerosis. The most common risk factors for developing atherosclerosis are smoking, dyslipidemia, high blood pressure, diabetes mellitus, male sex. Current cardiovascular risk prediction models are based on these traditional risk factors. Investigators attempt to identify additional risk factors that can improve our ability to accurately predict cardiovascular risk. C-reactive protein (CRP) is one possible marker of vascular inflammation. Several studies show that increased CRP levels are associated with the increased cardiovascular risk. Studies have established that increased CRP levels are associated with increased coronary heart disease risk in both genders and have a prognostic value for complications or new events. High CRP levels have been found in all types of coronary heart disease. Several studies have analyzed the association between CRP and ischemic stroke and have demonstrated that increased CRP level is a good predictor of cerebrovascular events. Some studies do not confirm independent relationship of CRP with stroke risk. Thus, the role of CRP as a predictor of ischemic stroke is still uncertain. A number of studies have shown that CRP is an independent risk factor for the development of PAD and a predictor of clinical outcomes, complications and mortality