This review focuses on the inflammatory component of atherosclerosis. It is well-known that biomarkers of inflammation, notably high-sensitivity C-reactive protein (CRP), add to traditional risk factors to better identify asymptomatic individuals and those with established cardiovascular disease who are at increased risk of having cardiovascular events. However, it is still not possible to show a relation of causation between inflammation and atherogenesis. Although the traditional risk factors have great utility in predicting cardiovascular risk, a majority of patients with coronary artery disease have only one or none of these risk factors. Therefore, studies to identify new biomarkers are important to refine our assessment of cardiovascular risk. The clinical application of these biomarkers of inflammation is that they should be used in addition to traditional risk factors. Large prospective studies have shown that biomarkers of inflammation have several applications such as prediction of first-ever cardiovascular events, determination of prognosis in those with established disease, providing a target of therapy, or serving to guide therapy. The authors underlined the fact that even though CRP has been shown not to participate directly in pathogenesis, its value as a risk marker must not be doubted. In addition, the authors highlighted the importance of refining risk prediction to individualize interventions and suggested that the clinical use of inflammatory biomarkers may help the practitioner to estimate residual risk.
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