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C-Reactive Protein and Cardiovascular Risk: Will the Controversy End after CANTOS?

Featured Article: Koenig W, Sund M, Frohlich M, Fischer HG, Lowel H, Doring A, et al. C-reactive protein, a sensitive marker of inflammation, predicts future risk of coronary heart disease in initially healthy middle-aged men: results from the MONICA (Monitoring Trends and Determinants in Cardiovascular Disease) Augsburg Cohort Study, 1984 to 1992. Circulation 1999;99:237–42.3

Rarely in cardiovascular medicine has a molecule split the scientific community for such a long time and provided a topic for many not only scientific but also emotional discussions. C-reactive protein (CRP)4, discovered in 1930 by Tillet and Francis, represents an important component of the innate immune system. In the 1990s, CRP was used to diagnose bacterial infections and to monitor antiinfective treatment. During this time, there was a paradigm change stressing the role of thrombosis and inflammation in triggering acute coronary syndrome events. However, as occasionally happens in science, just by coincidence CRP raised the interest of researchers as a potential predictor of cardiovascular …