Utility of inflammatory markers in the management of coronary artery disease

Certain markers of systemic inflammation are powerful predictors of cardiovascular events. Fibrinogen, C-reactive protein (CRP), and cytokines are among the inflammatory markers associated with various cardiovascular end points. Fibrinogen and CRP both have been associated with coronary artery disease (CAD) mortality in patients with stable angina. High-sensitivity CRP (hs-CRP) and fibrinogen also have prognostic value in patients with unstable angina. In addition to prognostic implications, several cardiovascular risk factors (eg, smoking, obesity, diabetes) are associated with high levels of fibrinogen and hs-CRP. Benefits from aspirin are more likely in patients whose hs-CRP levels are very high. Some fibrates decrease fibrinogen levels and hs-CRP. Statin therapy either reduces the CAD risk associated with system inflammation or lowers circulating levels of hs-CRP.