hs-CRP

High-sensitivity C-reactive protein (hsCRP) is a marker of inflammation that predicts incident myocardial infarction, stroke, peripheral arterial disease, and sudden cardiac death among healthy individuals with no history of cardiovascular disease, as well as recurrent events and death in patients with coronary syndromes. ^[1] The inflammatory biomarker hsCRP adds prognostic information on cardiovascular risk comparable to blood pressure or cholesterol. ^[2] Residual inflammation measured with hsCRP remains strongly predictive of recurrent events even in statin-treated patients, and elevated hsCRP in apparently healthy individuals identifies a higher-risk group in whom statin therapy reduces the risk of first major cardiovascular events even when LDL-cholesterol is normal. ^[3]

C-reactive protein is a phylogenetically conserved plasma protein that participates in the systemic response to inflammation, and its plasma concentration increases during inflammatory states. ^[4] CRP is a pattern-recognition molecule whose synthesis rises within hours after tissue injury or infection, consistent with a role in the innate immune response. ^[4] Because atherosclerosis involves an ongoing inflammatory response, low-grade chronic inflammation indicated by CRP prospectively defines the risk of atherosclerotic complications and adds to the prognostic information provided by traditional risk factors. ^[5] Although hsCRP is clinically useful as a biomarker, most mechanistic studies suggest CRP itself is unlikely to be a target for intervention, and it is best understood as a downstream surrogate for upstream interleukin-6 and interleukin-1 activity in the inflammatory cascade. ^[6]