C-reactive protein. Should it be considered a coronary risk factor?

C-reactive protein (CRP) is an acute phase reactant which is not associated with coronary atherosclerosis in many studies. However, it has been demonstrated in many, but not all, studies to predict cardiovascular events. Increased CRP levels may reflect tissue damage and inflammation not only in the arteries, but anywhere in the body. Elevated CRP levels may be induced by metabolic, infective, immunologic, or other processes. Increased CRP levels are probably an indirect marker of any increased cytokine response to inflammatory stimuli that are critical for atherosclerotic plaque progression and rupture. A large-scale prospective trial is needed to investigate whether reduction of elevated CRP will reduce cardiovascular events.