hs-CRP (high-sensitivity C-reactive protein)
A marker of low-grade systemic inflammation, and one of the more honestly contested numbers in preventive cardiology. Inflammation contributes to atherosclerotic plaque formation and rupture, but Mendelian randomisation evidence suggests CRP itself is largely a bystander rather than a direct causal driver, with upstream pathways such as IL-6 more likely to be doing the work. As a risk marker it still adds information; as a treatment target it does not.
Ridker PM, Danielson E, Fonseca FAH, et al. (JUPITER) “Rosuvastatin to Prevent Vascular Events in Men and Women with Elevated C-Reactive Protein.” N Engl J Med 2008;359:2195–2207 found that statin therapy in patients with normal LDL-C but hs-CRP ≥2mg/L significantly reduced major cardiovascular events. ACC/AHA guidelines accordingly list hs-CRP as an optional “risk-enhancing factor” for intermediate-risk patients — not a universal screen.
Ridker PM, et al. N Engl J Med. 2008. PubMed: PMID 18997196
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