C-Reactive Protein Risk Prediction: Low Specificity, High Sensitivity

Convincing evidence indicates that both local inflam-mation in the arterial wall and systemic signs of inflammation are important in atherogenesis and in complications of atherosclerotic disease. Consistent re-sults from more than 15 well-conducted prospective studies in initially healthy persons (1) have shown a strong and independent association between the circu-lating concentration of C-reactive protein (CRP)—the classic acute-phase reactant, measured by high-sensitiv-ity assays—and cardiovascular end points, including acute myocardial infarction, stroke, and progression of peripheral arterial occlusive disease. This strong associa-tion is seen for both primary and secondary prevention (patients with manifest atherosclerotic disease). In-creased CRP levels predict recurrent instability in pa-tients admitted with an acute coronary syndrome; i