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We would like to highlight that CRP is primarily an indicator of augmented inflammatory status, which is an active promotor of atherogenesis and trigger of acute coronary syndromes. Inflammatory process causing elevated CRP, even when primarily located outside of the cardiovascular system, can still promote atherosclerosis through a number of proatherogenic and prothrombotic mechanisms. Therefore, patients in whom elevated CRP indicates higher inflammatory risk also require very intensive management of CV status (e.g. intensification of statin therapy). In patients with very high hs-CRP levels (>10 mg/L), as was noted in some of the studies included in this meta-analysis, other causes of chronic systemic inflammation should be considered because their healing can additionally reduce systemic inflammatory risk, the progression of CAD and the onset of MACE. |
