VALUTAZIONE DELLA PROTEINA C-REATTIVA AD ELEVATA SENSIBILITÀ IN PREVENZIONE PRIMARIA

Salvatore Novo, Egle Corrado, Salvatore Novo, Egle Corrado

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

In an attempt to improve global cardiovascular risk prediction, considerable interest has focused onC-reactive protein (CRP), that has been shown in multiple prospective epidemiological studies to predictincident myocardial infarction, stroke, peripheral arterial disease, and sudden cardiac death.CRP is a hepatically-derived pentraxin that plays a key role in the innate immune response. StandardCRP tests determine levels which are increased up to 1000-fold in response to infection or tissue destruction,but cannot adequately assess the normal range. High-sensitive CRP detects levels of CRPwithin the normal range as well as higher levels proven to predict future cardiovascular events. Therelationship between a patient’s baseline plasma level of CRP and future vascular risk has been consistentin several studies, and in most cases has proven independent of major “traditional” risk factorssuch as age, smoking, cholesterol levels, blood pressure and diabetes. Several pharmacologicalagents proven to reduce vascular risk influence CRP levels. Other lipid-lowering agents reported toreduce CRP include niacin, fibrates, and gemfibrozil.Aspirin also has an intriguing interaction with CRP in that the magnitude of relative risk reductionattributable to aspirin in primary prevention appears to be greatest among those with elevatedCRP and declines proportionately in direct relation to CRP levels. Observational data, moreover, suggestpossible differential benefits for clopidogrel and abciximab on the basis of CRP levels before percutaneouscoronary interventions. As documented above for primary prevention, CRP is an independentpredictor of future cardiovascular events that adds prognostic information to lipid screening,to the metabolic syndrome, and to the Framingham risk score. An approach in primary preventionis to measure CRP only among those at intermediate risk as defined by the Framingham riskscore. In secondary prevention, the potential utility of CRP is less certain, as aggressive therapiesshould already be instituted and low-density lipoprotein evaluation provides an excellent method toassess statin efficacy
Original languageEnglish
Pages (from-to)327-334
Number of pages8
JournalGiornale Italiano di Cardiologia
Volume8
Publication statusPublished - 2007

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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