This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Blankenberg, S. Articles by Yusuf, S. Search for Related Content PubMed PubMed Citation Articles by Blankenberg, S. Articles by Yusuf, S. Pubmed/NCBI databases Substance via MeSH Related Collections Risk Factors for Stroke

(Circulation. 2006;114:1557-1560.)
© 2006 American Heart Association, Inc.

Editorial

The Inflammatory Hypothesis

Any Progress in Risk Stratification and Therapeutic Targets?

Stefan Blankenberg, MD; Salim Yusuf, MBBS, DPhil, FRSC

From the Department of Medicine II, Johannes Gutenberg-University Mainz, Germany (S.B.), and the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada (S.Y.).

Correspondence to Dr Salim Yusuf, McMaster University and Hamilton Health Sciences, 237 Barton St E, Hamilton, Ontario L8L 2X2, Canada. E-mail yusufs@mcmaster.ca

Key Words: Editorials • cardiovascular diseases • inflammation • stroke

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
About a decade ago, the prevailing wisdom was that conventional risk factors explained only about half of the risk for a myocardial infarction or stroke. However, most studies did not assess some of the newer lipid markers (such as the apolipoproteins) or measures of abdominal obesity, diet, or psychosocial factors and moreover did not try to quantify the population-attributable risk. Consequently, efforts to identify novel risk factors were undertaken to improve cardiovascular risk prediction.

Article p 1591

The hypothesis that inflammation is a central contributor to atherothrombosis has stimulated sustained efforts to characterize the specific molecules and pathways that may be involved and to identify biomarkers in humans that enable detection of underlying inflammatory activation to improve cardiovascular risk prediction. Ridker and coworkers¹ reported that systemic low-grade inflammation assessed by measurements of the acute-phase reactant C-reactive protein (CRP) is associated with future cardiovascular events in apparently healthy individuals. This intriguing concept stimulated intense interest in further investigating the ability of inflammatory markers to add information for cardiovascular risk stratification beyond that obtained from traditional risk factors.

	CRP as Predictor for Cardiovascular Events

 
The value of CRP for cardiovascular risk prediction has been assessed in 3 different clinical settings: apparently healthy individuals, stable patients at risk for cardiovascular events or with documented coronary heart disease, and patients presenting with acute coronary syndromes.

The utility of CRP for risk stratification has been proposed mainly in healthy individuals. Several large, prospective cohort studies have consistently reported that higher levels of CRP are associated with an increased risk for cardiovascular . . . [Full Text of this Article]

This article has been cited by other articles:

				L. K. Curtiss and P. S. Tobias Emerging role of Toll-like receptors in atherosclerosis J. Lipid Res., April 1, 2009; 50(Supplement): S340 - S345. [Abstract] [Full Text] [PDF]

				B. Pitt N-terminal pro-B-type natriuretic peptide concentrations >=100 ng/l increased risk of all-cause mortality Evid. Based Med., February 1, 2008; 13(1): 26 - 26. [Full Text] [PDF]

				R. R. S. Packard and P. Libby Inflammation in Atherosclerosis: From Vascular Biology to Biomarker Discovery and Risk Prediction Clin. Chem., January 1, 2008; 54(1): 24 - 38. [Abstract] [Full Text] [PDF]

				I. Tabas, K. J. Williams, and J. Boren Subendothelial Lipoprotein Retention as the Initiating Process in Atherosclerosis: Update and Therapeutic Implications Circulation, October 16, 2007; 116(16): 1832 - 1844. [Abstract] [Full Text] [PDF]

				R. Schnabel and S. Blankenberg Oxidative Stress in Cardiovascular Disease: Successful Translation From Bench to Bedside? Circulation, September 18, 2007; 116(12): 1338 - 1340. [Full Text] [PDF]

				P. M Ridker and B. M. Everett Letter by Ridker and Everett Regarding Article, "The Inflammatory Hypothesis: Any Progress in Risk Stratification and Therapeutic Targets?" Circulation, May 22, 2007; 115(20): e475 - e475. [Full Text] [PDF]

				S. Blankenberg and S. Yusuf Response to Letter Regarding Article, "The Inflammatory Hypothesis: Any Progress in Risk Stratification and Therapeutic Targets?" Circulation, May 22, 2007; 115(20): e476 - e476. [Full Text] [PDF]