How does C-reactive protein (CRP) affect the risk for coronary artery disease (CAD)?

Updated: Mar 30, 2020
  • Author: F Brian Boudi, MD, FACP; Chief Editor: Yasmine S Ali, MD, MSCI, FACC, FACP  more...
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C-reactive protein (CRP) is a protein in the blood that demonstrates the presence of inflammation, which is the body's response to injury or infection; CRP levels rise if inflammation is present. The inflammation process appears to contribute to the growth of arterial plaque, and in fact, inflammation characterizes all phases of atherothrombosis and is actively involved in plaque formation and rupture.

According to some research results, high blood levels of CRP may be associated with an increased risk of developing coronary artery disease (CAD) and having a heart attack. [3, 10] In the Jupiter trial, in healthy persons without hyperlipidemia but with elevated high-sensitivity CRP levels, the statin drug rosuvastatin significantly reduced the incidence of major cardiovascular events. [51]

The 2013 ACCF/AHA guideline for assessment of cardiovascular risk is based on expert opinion; they state that when risk-based decisions regarding initiation of pharmacological therapy are uncertain following quantitative risk assessment, measurement of C-reactive protein can be useful. Levels of at least 2 mg/L support revising the risk assessment upward.

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