Inflammatory biomarkers and risks of myocardial infarction, stroke, diabetes, and total mortality: implications for longevity.

Inflammation is recognized as a major etiologic determinant of multiple disease states including myocardial infarction, stroke, diabetes, and metabolic syndrome, and individuals with elevated levels of the inflammatory biomarker high-sensitivity C-reactive protein (hsCRP) are at increased risk of mortality and morbidity from these conditions. Novel screening algorithms, such as the Reynolds Risk Score, that incorporate inflammation can greatly improve risk detection in primary prevention. In high-risk secondary prevention settings such as acute coronary syndrome patients being treated with statin therapy, achieving low levels of plasma hsCRP concentration appears to be of similar importance as achieving low levels of LDL cholesterol. Whether inflammation in general or CRP in particular are appropriate targets for therapy remains controversial and is under investigation. Several novel methods to reduce CRP have been proposed, including direct inhibitors as well as antisense technologies.