C-reactive protein (CRP) as a marker in peripheral vascular disease.

Objective: To review the role of CRP as a marker for the prediction of development of Peripheral Vascular Disease (PVD) and as a prognostic indicator.

Methods: Search of the Cochrane Vascular Group Control Trials Register, Medline and Embase for all published studies on the role of CRP as a marker in peripheral vascular disease was undertaken.13 prospective studies were found.

Results: 12 of the 13 prospective studies showed a strong association between CRP and PVD. Three population studies involving 16,561 people, over a period of 6.5 to 12 years, revealed that high CRP levels approximately tripled the risk of developing PVD, independently of all other risk factors. Three case-control studies found that hsCRP was much higher in patients with PVD. Four other studies, which covered 2337 people, demonstrated that CRP levels were associated inversely with lower ankle brachial pressure index. One study conducted on 384 people failed to show a link between hsCRP and progression of ABPI. Two further small studies showed that raised pre and post intervention hsCRP were associated with restenosis after angioplasty.

Conclusions: CRP appears to be a strong predictor and marker of severity of PVD and also may predict the risk of restenosis after angioplasty.