How are C-reactive protein (CRP) cardiac markers characterized and what do they indicate?

Updated: Jul 30, 2021
  • Author: Kamal (Komo) Gursahani, MD, MBA; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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C-reactive protein (CRP), a nonspecific marker of inflammation, is considered to be directly involved in coronary plaque atherogenesis. Extensive studies beginning in the early 1990s showed that an elevated CRP level independently predicted adverse cardiac events at the primary and secondary prevention levels.

Data indicate that CRP is a useful prognostic indicator in patients with acute coronary syndrome (ACS), as elevated CRP levels are independent predictors of cardiac death, acute myocardial infarction (MI), and congestive heart failure (CHF). In one study, CRP was elevated in patients with unstable angina but not in those with angina caused by vasospasm; therefore, this marker may be more specifically associated with coronary artery inflammation related to atherosclerosis rather than injured myocardium. [77] In combination with troponin I (TnI) and brain-type natriuretic peptide (BNP), CRP may be a useful adjunct, but its nonspecific nature limits its use as a diagnostic cardiac marker for ACS in the emergency department (ED).

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