Cited by 417Lipoproteins and Cardiovascular HealthAcute Myocardial Infarction ResearchHealth Promotion and Cardiovascular Prevention

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Ridker, Paul M·2016·Journal of the American College of Cardiology

DOI 10.1016/j.jacc.2015.11.037

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Abstract

The inflammatory biomarker high-sensitivity C-reactive protein (hsCRP) adds prognostic information on cardiovascular risk comparable to blood pressure or cholesterol. Values <1, 1 to 3, and >3 mg/l indicate lower, average, or higher relative cardiovascular risk, respectively. Global risk algorithms that include hsCRP outperform those solely using Framingham covariates. Although diet, exercise, and smoking cessation are first steps for patients with a proinflammatory response, JUPITER (Justification for the Use of Statins in Prevention: an Intervention Trial Evaluating Rosuvastatin) trial data demonstrate that statins reduce by 47% the rate of first myocardial infarction, stroke, or confirmed cardiovascular death when given to patients with low-density lipoprotein-C levels of <130 mg/dl and hsCRP of >2 mg/l (hazard ratio: 0.53; 95% confidence interval: 0.40 to 0.69; p < 0.00001). In current U.S. guidelines, hsCRP carries a class IIb assessment and is most appropriate in primary prevention when clinical decisions to initiate statin therapy are uncertain. Ongoing multinational trials are pursuing whether reducing inflammation will decrease vascular event rates.

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Authors: Ridker, P. M.
Affiliations: Brigham and Women's Hospital (US)
Corresponding author: Ridker, Paul M
ORCID: Ridker, Paul M
Venue: Journal of the American College of Cardiology
Publisher: Elsevier BV
Published: 2016-02
Volume: 67
Issue: 6
Pages: 712-723
ISSN: 0735-1097 (ISSN-L)
DOI: 10.1016/j.jacc.2015.11.037
OpenAlex: W2264523161
Cited by: 414
References: 64
Citations by year: 2026: 54 · 2025: 51 · 2024: 45 · 2023: 47 · 2022: 35 · 2021: 35 · 2020: 48 · 2019: 34 · 2018: 30 · 2017: 19 · 2016: 16
FWCI: 6.54
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 381 d)
Locations: Journal of the American College of Cardiology (publishedVersion)
PubMed (publishedVersion)
Funders: Pfizer
AstraZeneca
American College of Cardiology Foundation
National Heart, Lung, and Blood Institute (U01HL101422)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
Keywords: high-sensitivity C-reactive protein, inflammation, cardiovascular risk, cardiovascular risk prediction, statins, rosuvastatin, JUPITER trial, primary prevention, Framingham risk factors, LDL cholesterol, myocardial infarction, stroke, cardiovascular mortality
MeSH terms: C-Reactive Protein, Cardiovascular Diseases, Humans, Predictive Value of Tests, Global Health, Reproducibility of Results, Biomarkers, Incidence, Survival Rate, Risk Assessment

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