I. A Marker of Risk
II. Clinical Studies
III. Perspective and Research Implications
GLOSSARY
allograft a graft between animals of the same species, but of different genotype.
angina chest pain caused by temporary lack of blood to an area of heart muscle cells, usually caused by severe obstruction of the artery supplying blood to the segment of cells.
atheroma the same as atherosclerosis, raised plaques filled with cholesterol, calcium, and other substances on the inner walls of arteries that obstruct the lumen and the flow of blood; the plaque of atheroma hardens the artery, hence the term atherosclerosis (sclerosis ¼ hardening).
Atherothrombosis thrombosis complicating a ruptured or fissured plaque of atheroma
dyslipidemia the same as hyperlipidemia, elevated blood choles¬terol, LDL cholesterol, triglycerides, or low HDL cholesterol.
myocardial infarction death of an area of heart muscle due to blockage of a coronary artery by blood clot and atheroma; medical term for heart attack or coronary thrombosis.
unstable angina severe angina usually occurring at rest.

• I. A MARKER OF RISK
  C-reactive protein (CRP) is an acute phase reactant pro¬duced by the liver in response to inflammatory cytokines (1L-1, 1L-6) and tumor necrosis factor-a (TNF-a). C-reactive protein has been identified as a marker of risk for coronary events independent of other factors.
• II. CLINICAL STUDIES A. Ridker et al.
  Study question: CRP and LDL cholesterol levels are both elevated in individuals at risk for cardiovascular events. This study sought population-based data that directly compared these two biological markers because such data are not available.
• III. PERSPECTIVE AND RESEARCH IMPLICATIONS
  Investigative methods for detecting vulnerable athero¬sclerotic plaques include intravascular ultrasonography, magnetic resonance imaging plaque thermography, and circulating markers such as CRP and cytokines may have a role in the future. Evidence is insufficient to warrant widespread screening with CRP. The measurement would be of practical value in patients with coronary artery disease and cardiovascular disease, with optimal levels of LDL cholesterol greater than 95 mg/dl (2.5 mmol/L; to convert values for LDL cholesterol to mmol per liter multiply by 0.02586).
• BIBLIOGRAPHY
  Blake, G., and Ridker, P. M. C-reactive protein and other inflammatory risk markers in acute coronary syndromes. J. Am. Coll. Cardiol., 41:37S–42S, 2003.

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