High sensitivity C-reactive protein as a predictor of myocardial infarction in low risk postmenopausal women

Problem: Research on novel biomarkers, such as high sensitivity C-reactive protein (hsCRP), for the prediction of myocardial infarction (MI) has increased over the past 10 years. Most studies, however, have primarily focused on middle-age men. Given that a large percentage of women are asymptomatic and without traditional risk factors and typical symptoms at the time of a MI, indentifying new biomarkers that predict MI risk in women is of critical need. This review focuses on C-reactive protein as a predictor of acute MI risk in women classified as low-risk using traditional methods. Methods: OVID, Pubmed, and The National Center for Biotechnology Information databases were searched for articles relevant to hsCRP as a predictor and risk factor for MI. Studies were included if they had direct measurements of hsCRP, included women in a separate analysis from men, women over age 45, and used traditional risk factors analysis to define low, intermediate, and high risk groups. Results: The original search, using hsCRP and women as key terms, produced 18,966 articles, with the final search resulting in 119 articles, of which 33 were selected based on the inclusion and exclusion criteria. Conclusions: After the literature search and review, it was clear that several large studies are in support of hsCRP as a predictor of cardiovascular disease and acute MI. However, studies in healthy women, specifically postmenopausal women, were lacking. Further research is warranted to determine if hsCRP could improve risk assessment and prediction of MI, particularly in women.