C-Reactive Protein (CRP) May Not Cause Cardiovascular Disease

Elevated levels of C-reactive protein (CRP) are associated with an increased risk for cardiovascular events, such as heart attack and stroke. But it has been unclear whether CRP actually causes these cardiovascular problems, or rather is merely a "marker" for increased risk. This question has potential importance, since drug companies are actively developing medications aimed specifically at reducing CRP levels. (Reducing CRP levels would not be expected to improve outcomes if CRP is merely a marker, and not a causitive agent.)

A new meta analysis published just before Christmas in Lancet strongly suggests that CRP is only a marker for risk. Investigators from the Netherlands analyzed data from over 160,000 patients who had been enrolled in 54 randomized clinical trials, and (employing complex statistical techniques) concluded that CRP appears unlikely to be the actual cause of cardiovascular events.

Drawing definitive conclusions from a meta analysis, however, is hazardous. Drug companies are unlikely to halt their efforts to find safe "anti-CRP" drugs just because of this new publication.

In the meantime, while the scientists sort all of this out, CRP does remain a potentially useful indicator of one's risk for heart disease - as long as you and your doctor understand how to interpret it.

Here is what you need to know about having your CRP measured, and here is what you might do if your CRP levels are found to be elevated.

_Sources:

_{The Emerging Risk Factors Collaboration. C-reactive protein concentration and risk of coronary heart disease, stroke and mortality: an individual participant meta-analysis. Lancet 2009; DOI:10.1016/S0140-6736(09)61717-7.}