C-Reactive Protein, Inflammation, and Cardiovascular Disease: Clinical Update

Two-and-a-half years ago, we presented C-reactive protein (CRP) data from the Women's Health Study, a large prospective study of 30,000 healthy middle-aged women followed over 10 years for the occurrence of first-ever cardiovascular events (the final results of the Women's Health Study regarding the effects of aspirin and of vitamin E randomization have just been published [N Engl J Med 2005;352:1293–304 and JAMA 2005;294:56–65]). We showed that high-sensitivity CRP is a very good predictor of vascular events in this population. Moreover, CRP provides prognostic information beyond low-density lipids (LDL). We identified a unique population—low-LDL, high-CRP individuals —that otherwise might have been missed. This was the impetus for the JUPITER trial, which I'll mention later.At all levels of LDL, at all levels of metabolic syndrome, and at all levels of Framingham risk, CRP provides additive information on vascular risk. In conjunction with Peter Wilson and Scott Grundy, we are develo...