Clinical Significance of C-Reactive Protein among Japanese for Predicting Atherosclerotic Events

There is growing evidence that local and systemic inflammation plays a role in the initiation and progression of atherosclerosis. Patients with acute coronary syndrome have increased CRP levels before onset . However, the significance of CRP measurement has not been confirmed in healthy Japanese subjects and patients with atherosclerotic diseases . Since 2000, we have started to measure hs-CRP using BN-II (Dade-Behring Co ., IL, USA) in more than 3000 subjects annually. The upper-limit of the normal range of hs-CRP is 1.0 mg/1 in Japanese. Careful consideration is required in interpreting hs-CRP values. Aging, obesity, and smoking increase the values, while weight reduction, and a moderate intake of alcohol reduce the values . The accumulation of numbers with regard to each component of metabolic syndrome indicates the elevation of hs-CRP in a stepwise manner. Patients with arrhythmia such as atrial fibrillation show elevated values. A prospective study on Japanese in the Tokyo area indicated a 22% increase in cardiovascular events in high hs-CRP subjects compared to normal hs-CRP groups. The usefulness of the determination of hsCRP with plasma lipids is confirmed when predicting high-risk subjects. (Ninge;i Dock 2007 ; 21 : 41-45)