High-sensitivity C-reactive protein and its role in coronary atherosclerotic disease: a review of current literature

Abstract Objective To review the role of high-sensitivity C-reactive protein (hsCRP) as a biomarker of inflammation in coronary atherosclerotic disease and its potential clinical applications. Methods A narrative review of key clinical trials, meta-analyses, and guideline recommendations was performed to evaluate the association between hsCRP levels, cardiovascular risk, and therapeutic interventions. Results Elevated hsCRP levels are associated with increased risk of coronary events, both in primary and secondary prevention settings. Statins, independent of their lipid-lowering effects, significantly reduce hsCRP levels and associated cardiovascular events. Anti-inflammatory agents such as canakinumab and colchicine also demonstrate benefit in reducing major adverse cardiovascular events, while newer agents like bempedoic acid show promising hsCRP-lowering effects. Current guidelines recommend selective hsCRP use for risk stratification, particularly in intermediate-risk patients. Conclusion hsCRP is a valuable biomarker reflecting residual inflammatory risk in coronary atherosclerosis. Incorporating hsCRP into routine clinical practice may enhance cardiovascular risk stratification and guide therapeutic decisions. Categories Cardiology, Internal medicine