Benjamin J. Ansell, MD, FACC

Recent research into the use of markers of inflammation to aid in cardiovascular risk assessment has focused on C-reactive protein, an acute-phase reactant found in atherosclerotic lesions. Serum levels of C-reactive protein are strongly associated with cardiovascular disease risk. Several clinical trials have shown that elevated C-reactive protein concentration predicts increased risk in persons with average or even below-normal levels of low-density lipoprotein cholesterol. When measured with the high-sensitivity assay, C-reactive protein has been shown to add to the predictive power of traditional cardiovascular risk factors and can enhance the 10-year Framingham Risk Score risk prediction. This article reviews the available evidence and addresses the potential for lowering C-reactive protein levels to reduce the risk of cardiovascular disease.