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Invited Critique
November 1, 2007

C-reactive Protein Level and Traditional Vascular Risk Factors in the Prediction of Carotid Stenosis—Invited Critique

Arch Surg. 2007;142(11):1071. doi:10.1001/archsurg.142.11.1071

Mullenix et al, in an accompanying article, measured high-sensitivity CRP levels along with a host of other traditional risk factors in a group of 146 patients undergoing duplex ultrasonography for possible carotid stenosis. They found that CRP levels were higher in patients with than in those without stenoses, and that CRP levels were stronger predictors of stenosis than anything else they measured (including smoking and LDL levels), even when corrected for statin use.

C-reactive protein is today's “hot” molecule. Atherosclerosis is increasingly viewed as an inflammatory process, and CRP seems to be a strong marker of systemic inflammation—the American Heart Association’s position that anyone with a CRP level of greater than 3.0 mg/L is in a “high-risk” category for cardiovascular events.1

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