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J Am Coll Cardiol, 2006; 47:19-31, doi:10.1016/j.jacc.2005.10.066
© 2006 by the American College of Cardiology Foundation
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C-Reactive Protein and Other Emerging Blood Biomarkers to Optimize Risk Stratification of Vulnerable Patients

Sotirios Tsimikas, MD, FACC*,*, James T. Willerson, MD, FACC{dagger} and Paul M. Ridker, MD, FACC{ddagger}

* Department of Medicine, Division of Cardiology, University of California, San Diego, San Diego, California
{dagger} St. Luke’s Episcopal Hospital/Texas Heart Institute, Houston, Texas
{ddagger} Center for Cardiovascular Disease Prevention, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts


Figure 1
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  		Figure 1 Additive value of high-sensitivity C-reactive protein after adjustment for traditional risk factors. Data are shown across all levels of low-density lipoprotein (LDL) cholesterol (right) and across all levels of calculated Framingham Risk (left). Adapted, with permission, from Ridker et al. (23).

 

Figure 2
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  		Figure 2 Cardiovascular event-free survival in apparently healthy American women according to plasma levels of low density lipoprotein (LDL)-cholesterol and high sensitivity C-reactive protein (CRP). Adapted, with permission, from Ridker et al. (23).

 

Figure 3
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  		Figure 3 Rates of recurrent myocardial infarction and cardiovascular death among acute coronary syndrome patients treated with statin therapy according to achieved levels of low density lipoprotein (LDL)-cholesterol and high sensitivity C-reactive protein (CRP) in the Pravastatin or Atorvastatin Evaluation and Infection Therapy–Thrombolysis In Myocardial Infarction 22 trial. Adapted, with permission, from Ridker et al. (40).

 

Figure 4
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  		Figure 4 The role of lipoprotein-associated phospholipase A2 (Lp-PLA2) in the breakdown of oxidized phospholipids. Reprinted, with permission, from Macphee (44). LDL = low-density lipoprotein; oxLDL = oxidized low-density lipoprotein.

 

Figure 5
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  		Figure 5 The role of myeloperoxidase in plaque vulnerability. Reprinted, with permission, from Hazen (66). HOCl = hypochlorous acid; MPO = myeloperoxidase; mRNA = messenger ribonucleic acid.

 

Figure 6
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  		Figure 6 Schematic representation of the chemiluminescent enzyme-linked immunoabsorbent assay to measure oxidized LDL-E06.

 

Figure 7
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  		Figure 7 Genetic structure of apolipoprotein (a) (top) and structure of lipoprotein (a) (bottom). Reprinted, with permission, from Hobbs and White (115).

 




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