Role of C-Reactive Protein in Acute Myocardial Infarction and Stroke: Possible Therapeutic Approaches

Paolo      Calabro; Enrica      Golia; Edward      T.H. Yeh

doi:10.2174/138920112798868764

Abstract

Myocardial infarction (MI) and stroke are relevant clinical issues in Western Countries for morbidity and mortality. In the last decades, great interest has been paid to the identification of non-traditional risk factors for a better stratification of patients and to recognize those at higher risk, who might particularly benefit from a more aggressive approach. In this field, C-reactive protein (CRP) is the most extensively studied novel marker, since it seems related to several stages of atherogenesis, from its beginning to clinical events (i.e. acute coronary syndromes - ACS). Among its possible pathogenetic role both in coronary artery disease (CAD) and ischemic stroke, several studies have shown that CRP could be used to predict first ever MI and stroke in healthy subjects, as well as outcome in acute settings. Moreover, a decrease of CRP levels can be achieved by several therapies, first of all statins, and this seems to be associated with a better outcome. Then a possible role for CRP to guide treatment of patient with ACS and stroke has been claimed and need to be specifically addressed by large randomized controlled trials.

Keywords: Vascular inflammation, CRP, cardiovascular diseases, cerebrovascular diseases, Myocardial infarction (MI), atherogenesis, acute coronary syndromes - ACS, coronary artery disease (CAD), ischemic stroke,, inflammatory response, atherothrombotic disease, cerebrovascular disease, acute phase proteins, leukocytes recruitment, endothelial dysfunction,, nitric oxide synthase, vascular smooth muscle cells (VSMCs), macropynocitosis