Non-cardiovascular determinants of C-reactive protein levels in patients with cardiovascular diseases

C-reactive protein (CRP) plasmatic levels might increase in patients with acute coronary syndrome (ACS) or atherosclerosis and evaluation of CRP is relevant for prognosis in case of ischemic heart disease. This clear role played by CRP in risk stratification of cardiovascular diseases is however biased by non-cardiac determinants: genetic heritable factors, seasonal or daily variability, and gender differences probably based on hormonal differences. Also non-steroidal hormones seem to be involved in CRP determinism, in a complicated interaction not easy to extricate. Nevertheless, CRP determination in patients with ACS should be considered as crucial for its prognostic relevance, even after a careful consideration of all these bias factors. (C) 2006 Elsevier Ireland Ltd. All rights reserved.