C-reactive protein: a new golden marker of cardiovascular risk.

The need for new cardiovascular risk factors, due to the limitations of traditional factors, is pointed out. Recent views regarding the role of inflammation in the evolution of the atherosclerotic process, namely in the formation of the atheroma plaque, its progression and rupture, and initiation of acute coronary events, are briefly summarized. These events point to the possibility that inflammatory markers could constitute new markers of cardiovascular risk. Amongst them, C-reactive protein (CRP)--particularly high sensitivity CRP (hsCRP)--has been found to be a 'golden marker' in this field. Data are presented indicating that CRP, rather than being merely an epiphenomenon of inflammation, in fact constitutes a pathogenic agent of the atherosclerotic process. The importance of CRP elevation in acute coronary events, in revascularization interventions, in other situations of cardiovascular risk and even in apparently healthy individuals is outlined. The performance of CRP is then compared with that of traditional risk factors. Finally, the need for studies to discover whether a decrease in CRP levels, as obtained with several pharmacological agents, is accompanied by a simultaneous reduction of cardiovascular risk is emphasized.