HUMAN C-reactive protein (CRP) was originally observed in the plasma of patients with acute infections and was found to react with the C-polysaccharide of the pneumococcus.1 It is an acute-phase reactant, because of the pronounced rise in concentration after tissue injury or inflammation. This diagnostically sensitive but nonspecific marker for inflammation is produced primarily by the liver but also by lymphocytes.2 C-reactive protein appears to recognize both foreign pathogens and damaged host cells and can initiate their elimination by interacting with humoral and cellular effector systems in the blood.3 The work of Ross and others has clearly shown that arteriosclerosis involves a chronic inflammatory process.4 Thus, it is not surprising that a series of studies have now found a significant positive relationship between CRP concentration and coronary artery disease (CAD),5,6 although it remains unclear that this relationship is independent of other inflammatory markers.7 Hence, a 70-year-old test used to detect acute inflammation has now become a potential important marker for CAD. This commentary raises questions associated with the use of CRP as a screening device for CAD in asymptomatic patients.
Thank you for submitting a comment on this article. It will be reviewed by JAMA Internal Medicine editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest*
Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 20
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
Users' Guides to the Medical Literature
An Illustration of Bias and Random Error
All results at
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.