<International Circulation>:The use of multiple biomarkers in cardiovascular disease has been receiving increased attention. Elevated levels of inflammatory markers indicate an increased risk of coronary heart disease. What are the most important inflammatory biomarkers for the evaluation of cardiovascular risk?

    Prof. Libby: I have a special perspective on this topic， coming from Brigham and Women’s Hospital， where so much work has been performed by my colleague and friend， Dr. Paul Ridker， regarding C-reactive protein measured with a high-sensitivity assay (hsCRP) as a biomarker of cardiovascular risk. The investigation of biomarkers has also been rather intense in our TIMI (Thrombolysis in Myocardial Infarction) group. It will be up to practitioners and guideline committees to consider the data being provided on C-reactive protein in generating guidelines and informing their practice， but from my personal “Brigham-centric” perspective， it is going to be hard to beat hsCRP as a biomarker of prospective cardiovascular risk for a variety of serendipitous and fundamental reasons. While C-reactive protein is most likely not in the causal pathway for cardiovascular complications of atherosclerosis， it is a very robust and high-fidelity biomarker because of its dynamic range， its assay’s simplicity and reproducibility， and its other properties. We believe that we have provided the community with some evidence regarding the ability to select people for statin therapy based on their inflammatory status in the JUPITER trial， which was led by Dr. Ridker， and we certainly look forward to trying to attest the proposition that anti-inflammatory therapies do not affect the lipid profile as the statins do. It might also benefit those who have levels of hsCRP that are elevated or above the median — s