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Reviews |
From the Center for Cardiovascular Disease Prevention and the Leducq Center for Cardiovascular Research, Department of Medicine, Brigham and Womens Hospital, Harvard Medical School, Boston, Mass.
Correspondence to Dr Paul M. Ridker, Center for Cardiovascular Disease Prevention, Brigham and Womens Hospital, 900 Commonwealth Ave East, Boston, MA 02215. E-mail pridker{at}partners.org
Abstract
Inflammatory processes play a pivotal role in the pathogenesis of atherosclerosis and mediate many of the stages of atheroma development from initial leukocyte recruitment to eventual rupture of the unstable atherosclerotic plaque. Elevated plasma levels of several markers of the inflammatory cascade have been shown to predict future risk of plaque rupture. These markers include P-selectin, interleukin-6, tumor necrosis factor-
, soluble intercellular adhesion molecule-1, and C-reactive protein (CRP). Produced in the liver in response to interleukin-6, CRP has emerged as the most powerful inflammatory marker of future cardiovascular risk. Initially considered an innocent bystander in the atherosclerotic process, recent evidence suggests that CRP may have direct proinflammatory effects. Numerous large-scale, prospective studies have found that elevated baseline levels of CRP are a strong independent predictor of future vascular risk. Furthermore, aspirin and statin therapy appear to be particularly effective among individuals with high CRP levels. The addition of CRP screening to traditional lipid testing has the potential to identify individuals at high risk for future cardiovascular events who may benefit from targeted preventive interventions.
Key Words: inflammation risk factors atherosclerosis
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L. G. Futterman and L. Lemberg High-Sensitivity C-Reactive Protein Is the Most Effective Prognostic Measurement of Acute Coronary Events Am. J. Crit. Care., September 1, 2002; 11(5): 482 - 486. [Full Text] [PDF] |
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S. Verma, C.-H. Wang, S.-H. Li, A. S. Dumont, P. W.M. Fedak, M. V. Badiwala, B. Dhillon, R. D. Weisel, R.-K. Li, D. A.G. Mickle, et al. A Self-Fulfilling Prophecy: C-Reactive Protein Attenuates Nitric Oxide Production and Inhibits Angiogenesis Circulation, August 20, 2002; 106(8): 913 - 919. [Abstract] [Full Text] [PDF] |
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S. Blankenberg, L. Tiret, C. Bickel, D. Peetz, F. Cambien, J. Meyer, H. J. Rupprecht, and for the AtheroGene Investigators Interleukin-18 Is a Strong Predictor of Cardiovascular Death in Stable and Unstable Angina Circulation, July 2, 2002; 106(1): 24 - 30. [Abstract] [Full Text] [PDF] |
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S. M. Grundy Obesity, Metabolic Syndrome, and Coronary Atherosclerosis Circulation, June 11, 2002; 105(23): 2696 - 2698. [Full Text] [PDF] |
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I. Loftus and M. Thompson The role of matrix metalloproteinases in vascular disease Vascular Medicine, May 1, 2002; 7(2): 117 - 133. [Abstract] [PDF] |
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S. Verma, S.-H. Li, M. V. Badiwala, R. D. Weisel, P. W.M. Fedak, R.-K. Li, B. Dhillon, and D. A.G. Mickle Endothelin Antagonism and Interleukin-6 Inhibition Attenuate the Proatherogenic Effects of C-Reactive Protein Circulation, April 23, 2002; 105(16): 1890 - 1896. [Abstract] [Full Text] [PDF] |
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