scholarly journals The Role of C-reactive Protein in Patient Risk Stratification and Treatment

2021 ◽  
Vol 16 ◽  
Author(s):  
Ramón Arroyo-Espliguero ◽  
María C Viana-Llamas ◽  
Alberto Silva-Obregón ◽  
Pablo Avanzas
Keyword(s):  
Risk Stratification ◽  
Cardiovascular Events ◽  
Specific Treatment ◽  
Cardiovascular Prevention ◽  
Chronic Inflammatory Disease ◽  
Residual Risk ◽  
C Reactive Protein ◽  
Inflammatory Biomarker ◽  
Reactive Protein

Atherosclerosis is a chronic inflammatory disease. Several circulating inflammatory markers have been proposed for clinical use due to their ability to predict future cardiovascular events and may be useful for identifying people at high risk who might benefit from specific treatment to reduce this risk. Moreover, the identification of new therapeutic targets will allow the development of drugs that can help reduce the high residual risk of recurrence of cardiovascular events in patients with coronary artery disease. The clinical benefits of reducing recurrent major cardiovascular events recently shown by canakinumab and colchicine have renewed the cardiology community’s interest in inflammation as an aetiopathogenic mechanism for atherosclerosis. This review explores the use of C-reactive protein, which is the most frequently studied biomarker in this context; the concept of residual risk in primary and secondary cardiovascular prevention; and the current recommendations in international guidelines regarding the role of this inflammatory biomarker in cardiovascular risk stratification.

scholarly journals Diabetes predicts severity of COVID‐19 infection in a retrospective cohort: A mediatory role of the inflammatory biomarker C‐reactive protein

2021 ◽  
Vol 93 (5) ◽  
pp. 3023-3032
Author(s):  
Huilin Koh ◽  
Angela Mei Chung Moh ◽  
Ester Yeoh ◽  
Yi Lin ◽  
Serena Kiat Mun Low ◽  
...  
Keyword(s):  
Retrospective Cohort ◽  
C Reactive Protein ◽  
Inflammatory Biomarker ◽  
Reactive Protein

scholarly journals Improved Prognostic Value in Predicting Long-Term Cardiovascular Events by a Combination of High-Sensitivity C-Reactive Protein and Brachial–Ankle Pulse Wave Velocity

2021 ◽  
Vol 10 (15) ◽  
pp. 3291
Author(s):  
Hack-Lyoung Kim ◽  
Woo-Hyun Lim ◽  
Jae-Bin Seo ◽  
Sang-Hyun Kim ◽  
Joo-Hee Zo ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Risk Stratification ◽  
Cardiovascular Events ◽  
Prognostic Value ◽  
Pulse Wave ◽  
High Sensitivity ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Hs Crp

Background: Both C-reactive protein (CRP) and arterial stiffness are associated with the development of cardiovascular disease (CVD). This study was performed to investigate whether a combination of these two measurements could improve cardiovascular risk stratification. Methods: A total of 6572 consecutive subjects (mean age, 60.8 ± 11.8 years; female, 44.2%) who underwent both high-sensitivity CRP (hs-CRP) and brachial–ankle pulse wave velocity (baPWV) measurement within 1 week were retrospectively analyzed. Major adverse cardiovascular events (MACE), including cardiovascular death, acute myocardial infarction, coronary revascularization, and stroke were assessed during the clinical follow-up. Results: During a mean follow-up period of 3.75 years (interquartile range, 1.78–5.31 years), there were 182 cases of MACE (2.8%). The elevated baPWV (≥1505 cm/s) (hazard ratio (HR), 4.21; 95% confidence interval (CI), 2.73–6.48; p < 0.001) and hs-CRP (≥3 mg/L) (HR, 1.57; 95% CI, 1.12–2.21; p < 0.001) levels were associated with MACE even after controlling for potential confounders. The combination of baPWV and hs-CRP further stratified the subjects’ risk (subjects with low baPWV and hs-CRP vs. subjects with high baPWV and hs-CRP; HR, 7.08; 95% CI, 3.76−13.30; p < 0.001). Adding baPWV information to clinical factors and hs-CRP had an incremental prognostic value (global Chi-square score, from 126 to 167, p < 0.001). Conclusions: The combination of hs-CRP and baPWV provided a better prediction of future CVD than either one by itself. Taking these two simple measurements simultaneously is clinically useful in cardiovascular risk stratification.

Increased C-Reactive Protein in Young Adult Patients with Migraine

Cephalalgia ◽  
2007 ◽  
Vol 27 (7) ◽  
pp. 843-846 ◽  
Author(s):  
FH Vanmolkot ◽  
JN de Hoon
Keyword(s):  
At Risk ◽  
Young Adult ◽  
Prospective Studies ◽  
Cardiovascular Events ◽  
Adult Patients ◽  
C Reactive Protein ◽  
Reactive Protein

Interictal serum C-reactive protein (CRP) was measured in 50 young adult patients with migraine and compared with 50 controls. The median CRP level was 1.42 mg/l in patients with migraine and 0.90 mg/l in controls ( P = 0.03). This finding supports the role of inflammation in migraine, but needs confirmation in larger controlled studies. Prospective studies may establish whether measurements of CRP can identify patients with migraine at risk for cardiovascular events.

scholarly journals High-sensitivity C-reactive protein and interleukin-6 as risk predictors in patients with stable angina pectoris

2020 ◽  
Vol 7 (9) ◽  
pp. 1322
Author(s):  
Shekhar Kunal ◽  
Pradeep Kumar Meena ◽  
Pooja Pathak ◽  
Himanshu Mahla ◽  
Kashish Gupta ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Stable Angina ◽  
Cardiovascular Events ◽  
High Sensitivity ◽  
Major Adverse Cardiovascular Events ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Vessel Disease ◽  
Significant Difference ◽  
Hs Crp

Background: Cardiovascular diseases are a leading cause of morbidity and mortality especially in developing countries such as India. Biomarkers such as high-sensitivity C-reactive protein (Hs-CRP) and interleukin-6 (IL-6) can help in risk stratification and better management of patients with stable angina.Methods: This was a prospective observational study wherein symptomatic patients with stable angina were enrolled. Coronary angiogram was done in those consenting to the procedure. Severity of coronary stenosis was graded as per the modified Gensini score (mGS). Hs-CRP and IL-6 levels were determined pre-procedure and 24 hours post percutaneous coronary intervention (PCI). Based on angiographic profile, patients were subdivided into four groups: group 1: normal coronaries, group 2: single vessel disease, group 3: double vessel disease and group 4: triple vessel disease. Primary outcome was occurrence of major adverse cardiovascular events over one-year period.Results: A total of 158 patients completed the study with a mean age of 62.8±9.6 years. A significant difference was observed between the four groups in terms of age, Hs-CRP and IL-6 levels. Of the 124 patients undergoing PCI, significant difference was observed in terms of pre and post procedure Hs-CRP (P<0.0001) and IL-6 levels (P<0.0001). Strong positive correlation was seen between Hs-CRP and IL-6 levels with modified Gensini scoring (mGS). Patients with MACE (15/158; 9.4%) had significantly higher levels of Hs-CRP and IL-6. Multivariate logistic regression analysis revealed that Hs-CRP, IL-6, ΔHs-CRP and ΔIL-6 were independent predictors of major adverse cardiovascular events (MACE).Conclusions: Hs-CRP and IL-6 levels were independent predictors of outcomes and can be used for risk stratification in these patients..

scholarly journals Inflammatory biomarkers in pregnant women with COVID-19: a retrospective cohort study

2020 ◽  
Author(s):  
ANDREA LOMBARDI ◽  
Silvia Duiella ◽  
Letizia Li Piani ◽  
Ferruccio Ceriotti ◽  
Massimo Oggioni ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Post Partum ◽  
Viral Disease ◽  
Inflammatory Biomarkers ◽  
C Reactive Protein ◽  
Prognostic Role ◽  
Oxygen Supplementation ◽  
Inflammatory Biomarker ◽  
Reactive Protein

Coronavirus disease 2019 is a pandemic viral disease affecting also obstetric patients and uncertainties exist about the prognostic role of inflammatory biomarkers and hemocytometry values in patients with this infection. To clarify that, we assessed the values of several inflammatory biomarkers and hemocytometry variables in a cohort of obstetric patients hospitalized with coronavirus disease 2019 and we correlated the values at admission with the need of oxygen supplementation during the hospitalization. Overall, among 27 (61%) pregnant women and 17 (39%) post-partum women, 6 (14%) patients received oxygen supplementation and 2 (4%) required admission to intensive care unit but none died. During hospitalization neutrophils (p=0.002), neutrophils to lymphocytes ratio (p=0.037) and C reactive protein (p<0.001) decreased significantly, whereas lymphocytes (p<0.001) and platelets (p<0.001) increased. Leukocytes and lymphocytes values at admission were correlated with oxygen need, with respectively a 1% and 5% higher risk of oxygen supplementation for each 1,000 cells decrease. Overall, in obstetric patients hospitalized with coronavirus disease 2019, C reactive protein is the inflammatory biomarker that better mirrors the course of the disease whereas D-dimer or ferritin are not reliable predictors of poor outcome. Care to the need of oxygen supplementation should be reserved to patients with reduced leukocytes or lymphocytes values at admission.

scholarly journals Interplay between hypercholesterolaemia and inflammation in atherosclerosis: Translating experimental targets into clinical practice

2018 ◽  
Vol 25 (9) ◽  
pp. 948-955 ◽  
Author(s):  
José Tuñón ◽  
Magnus Bäck ◽  
Lina Badimón ◽  
Marie-Luce Bochaton-Piallat ◽  
Bertrand Cariou ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Cardiovascular Events ◽  
Density Lipoprotein ◽  
Cardiovascular Prevention ◽  
Lipid Lowering ◽  
Receptor Protein ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
The Future ◽  
Anti Inflammatory

Dyslipidaemia and inflammation are closely interconnected in their contribution to atherosclerosis. In fact, low-density lipoprotein (LDL)-lowering drugs have anti-inflammatory effects. The Canakinumab Antiinflammatory Thrombosis Outcome Study (CANTOS) has shown that interleukin (IL)-1β blockade reduces the incidence of cardiovascular events in patients with previous myocardial infarction and C-reactive protein levels >2 mg/L. These data confirm the connection between lipids and inflammation, as lipids activate the Nod-like receptor protein 3 inflammasome that leads to IL-1β activation. LDL-lowering drugs are the foundation of cardiovascular prevention. Now, the CANTOS trial demonstrates that combining them with IL-1β blockade further decreases the incidence of cardiovascular events. However, both therapies are not at the same level, given the large evidence showing that LDL-lowering drugs reduce cardiovascular risk as opposed to only one randomized trial of IL-1β blockade. In addition, IL-1β blockade has only been studied in patients with C-reactive protein >2 mg/L, while the benefit of LDL-lowering is not restricted to these patients. Also, lipid-lowering drugs are not harmful even at very low ranges of LDL, while anti-inflammatory therapies may confer a higher risk of developing fatal infections and sepsis. In the future, more clinical trials are needed to explore whether targeting other inflammatory molecules, both related and unrelated to the IL-1β pathway, reduces the cardiovascular risk. In this regard, the ongoing trials with methotrexate and colchicine may clarify whether the cardiovascular benefit of IL-1β blockade extends to other anti-inflammatory mechanisms. A positive result would represent a major change in the future treatment of atherosclerosis.

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