Clinical implications of C-reactive protein as a predictor of vascular risk

Abstract

Purpose: To describe the role of C-reactive protein (CRP) as a marker of risk for coronary heart disease (CHD) and its role in risk reduction and disease prevention for the primary care provider.

Data sources: Extensive review of scientific literature on CRP and CHD.

Conclusions: Despite the scientific knowledge we have gained about prevention, risk factors, detection, and treatment, there are still high rates of CHD and acute coronary syndromes in the United States. With greater understanding of the role of inflammation in atherothrombotic disease, much attention has been given to monitoring CRP as a marker of risk for CHD. Guidelines for the use of CRP in clinical practice have been developed by the American Heart Association and Centers for Disease Control and Prevention; however, there is little specific guidance on how primary care providers should apply pharmaceutical strategies to reduce elevated levels of CRP.

Implications for practice: There is increasing evidence that CRP is an independent risk factor for CHD, can be a valuable tool in assessing at-risk populations, and provide additional information for the prevention of cardiovascular disease, which can assist the nurse practitioner target patients who may need lifestyle modifications that traditional screening tests may not identify.