The role of inflammation in cardiovascular disease.

The article in this issue by Gussekloo et al,1 “C-reactive protein is a strong but nonspecific risk factor of fatal stroke in elderly persons,” demonstrates 2 important points. First, for maximum predictive value, a variable such as C-reactive protein (CRP) should preferably be a risk factor for a specific outcome rather than for a broad range of unrelated outcomes such as stroke, coronary heart disease, cancer, and total mortality. There are some risk factors such as cigarette smoking and radiation exposure that are associated with many different outcomes, and future work may show that CRP falls into this important category. However, in general, the specificity of an association is an important component, often reflecting a causal relationship. These investigators determined that elevated CRP is …