Original artcileInflammation and atherosclerosis: role of C-Reactive protein in risk assessment
Section snippets
Overview of atherosclerosis: an inflammatory disease
Atherosclerotic plaque development begins with endothelial cell activation, including overexpression of leukocyte adhesion proteins (Figure 1). 1, 2 Triggers of this inflammatory response may include oxidized lipoproteins, hypertension, diabetes mellitus, and conditions such as obesity. The healthy endothelium resists prolonged leukocyte attachment. Expression of adhesion molecules, such as vascular cell adhesion molecule–1 (VCAM-1), enhances the recruitment of inflammatory cells from the
Role of inflammatory markers in risk assessment: C-reactive protein and cardiovascular disease
One of the great success stories of modern medicine is the ability to harness the basic knowledge of cholesterol and its metabolism, with clinical use of this knowledge allowing the modification of plasma cholesterol levels in a way that uniformly improves clinical outcomes. Although determination of plasma lipid profiles constitutes an important component of risk assessment for atherosclerosis, the picture provided by lipid profiles alone is incomplete. Castelli3 demonstrated that plasma total
Potential clinical utility of C-reactive protein measurement
The suitability of plasma CRP assay for clinical application compares favorably with determination of other inflammatory markers.11 For example, there is no standard assay for measuring lipoprotein(a), and circadian variations in fibrinogen make its measurement difficult. Although measurement of homocysteine is reliable, prospective data on its predictive utility are inconsistent, as are prospective data on utility of the lipoprotein(a).4 The predictive abilities of both plasma hs-CRP and
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