C-Reactive Protein and Coronary Heart Disease: Predictive Test or Therapeutic Target?

Abstract

BACKGROUND:The hepatocyte-derived acute-phase reactant C-reactive protein (CRP) has been the subject of intense research over the last 2 decades for its possible role in the pathogenesis of cardiovascular diseases. This research has spawned interest in the use of the blood concentration of CRP for predicting a first coronary heart disease (CHD) event, which has been made possible with the development of high-sensitivity CRP (hsCRP) assays that can measure the typically low concentrations of CRP that circulate in the absence of an overt infective or inflammatory episode, and as a potential causal factor that might be targeted therapeutically. The research has encompassed observational and genetic epidemiology, basic science studies with cells and tissues, experiments with animal models and humans, and randomized trials (although not of specific CRP-lowering therapies as yet). CONTENT:We focus on investigations of the potential role of small differences in basal hsCRP concentration seen in healthy individuals and the relationship of such differences to the long-term risk of a first CHD event, rather than on research devoted to the high acutephase CRP concentrations, which occur after acute atherothrombotic events and can influence the severity of ischemic tissue damage and the subsequent prognosis. We concentrate mainly on research findings at the translational interface and draw on evidence from human observational and genetic epidemiology, as well as from randomized trials.

Molecular genetics of atherosclerosis

“…CRP is an acute phase reactant and has a prognostic value in atherosclerotic diseases (Rifai and Ridker 2001). Polymorphisms in the CRP gene that were associated with marked increases in CRP levels could predict increase in the risk of ischemic vascular disease (Hingorani et al 2009;Zacho et al 2008). The presence of high producer CRP genotype was also demonstrated to be associated with subclinical carotid artery atherosclerosis in young Finnish men (Eklund et al 2008).…”

Ancestry as a Determinant of Mean Population C-Reactive Protein Values

“…assessing predictive utility, 8,9 CRP performed only modestly well, and its performance as a predictor for coronary disease was similar to blood pressure (BP) and low-density lipoprotein (LDL) cholesterol, whose use in isolation for assessment of cardiovascular risk has been abandoned in many healthcare settings in favor of risk scores (http://www.sign.ac.uk/pdf/sign97. pdf; http://www.nice.org.uk/nicemedia/pdf/CG67FullGuideline1.…”

Periodontal and systemic health conditions of the patients treated in the student clinic of department of periodontology betweeen the years 2012-2014

“…C-reactive protein (CRP) gibi kandaki enflamasyon markerlarının seviyesinin kardiyovasküler hastalık için bir risk göstergesi olduğu belirtilmiştir. 42,43 Periodontal hastalıklarda enflamasyonla ilişkili olarak artış gösteren CRP, interlökin 6, interlökin 8, transforming growth factor-α gibi sistemik enflamasyon göstergelerinin aterogeneze ve periodontitisli hastalarda aterom plaklarının rüptürüne katkıda bulunduğu gösterilmiştir. 44 Bununla birlikte periodontitis gibi kronik enflamatuvar hastalıkların kardiyovasküler hastalıklar için potansiyel sistemik enflamatuvar risk olduğu ve endotelyal disfonksiyona yol açtığı belirtilmiştir.…”