High-Sensitivity C-Reactive Protein: A Useful Marker for Cardiovascular Disease Risk Prediction and the Metabolic Syndrome

Every year, 1.3 million Americans suffer a myocardial infarction with only one half of them exhibiting evidence of dyslipidemia. The identification of additional risk factors for cardiovascular disease is therefore of paramount importance. Of the examined novel biochemical markers, high-sensitivity C-reactive protein (hs-CRP) is the most promising. To date, 22 prospective epidemiologic studies have demonstrated that hs-CRP is a strong predictor of future vascular disease, 6 cohort studies have shown that hs-CRP measurements add prognostic value beyond that available from the Framingham risk score, and 8 cohort studies have confirmed that hs-CRP adds prognostic information in the metabolic syndrome and in the prediction of type 2 diabetes (1). These studies, done by various groups in Europe and the United States, examined middle-aged and elderly men and women, and some included different ethnic and racial groups. As a result of these findings and the fact that hs-CRP can be reliably and accurately measured by clinical laboratories, the American Heart Association (AHA) and the CDC issued joint guidelines about the implementation of hs-CRP measurement as part of the global risk assessment of cardiovascular disease (2).In this Journal, Levinson et al. (3) recently …