Markers of Inflammation and Oxidant Stress in Coronary Heart Disease

Currently, there are no validated biomarkers of either inflammation or oxidant stress that can be used predictably for drug intervention in CHD patients. C-reactive protein (CRP), whose biological function is undetermined, has been proposed as a potential marker of inflammation, particularly in patients with acute coronary syndromes (ACS).6 Whether CRP is produced in response to inflammation or contributes directly to an inflammatory response is still unknown. However, elevated plasma CRP levels may represent an independent risk factor for CHD in the general population, even in subjects with near-normal cholesterol levels.1'6 Subjects with the lowest quintile of plasma cholesterol had a twofold higher risk of CHD when their plasma CRP levels fell in the highest CRP quintile. Similarly, subjects having plasma cholesterol levels in the highest quintile doubled their CHD risk as their CRP levels increased from the lowest to the highest quintile. Subjects with near-normal cholesterol levels and the highest CRP quintile were as much at risk as subjects with the highest quintile of plasma cholesterol and the lowest quintile of CRP. Plasma CRP levels may account in part for the majority of the CHD population who are at risk even though they have near-normal levels of plasma cholesterol. In elderly males and females, subjects with plasma CRP levels above 3mgL_ 1 had an increased cumulative 10-year risk of developing CHD.

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