Inflammatory residual risk: An emerging target to reduce cardiovascular disease?

Abstract

Following these studies, atherosclerosis and its complications are no longer viewed as mere consequences of high levels of cholesterol, blood pressure, plasma glucose, or cigarette smoking. They are now considered complex, multifactorial, and progressive disorders, in which proinflammatory biological pathways are not only involved but seem to play a major role. These proinflammatory factors may promote endothelial dysfunction and local inflammation, favoring vascular wall damage and development of atherosclerotic plaque, which may significantly contribute to several clinical manifestations.Since the 1990s, the scientific community identified in elevated serum high-sensitivity C-reactive protein (hsCRP) levels, a marker of the vascular inflammatory process that predicts the progression of atherosclerotic plaque, its recurrent instability, and a worse outcome.2 It was clear that independently or beside low-density lipoprotein (LDL) levels, or the concomitant presence of the other risk factors, hsCRP levels could predict outcomes.3