Hs-CRP as a biomarker for atherosclerosis progression and cardiovascular risk: a systematic review

Background High-sensitivity C-reactive protein (hs-CRP) has emerged as a significant biomarker for assessing inflammatory activity in atherosclerosis, which may predict sudden death, especially in individuals with advanced atherosclerotic disease or those at high risk for acute events. Methods This systematic review aimed to evaluate the significance of changes in hs-CRP levels over time in the population with atherosclerosis; the frequency of cardiovascular events, including mortality, stroke, and myocardial infarction; and changes in the progression of atherosclerosis. We conducted a comprehensive search of the PubMed, Scopus, Web of Science, and Embase databases up to January 2026 to identify observational and cohort studies evaluating high hs-CRP levels in patients with atherosclerosis, and to evaluate the quality of studies using the Newcastle-Ottawa Scale (NOS). Results Our results included six studies involving baseline and follow-up hs-CRP values that showed a relationship between elevated baseline hs-CRP levels and an increased incidence of atherosclerotic progression that led to cardiovascular events. In addition, the variability in inflammation severity across different clinical events was displayed by the range of baseline hs-CRP measurements across different patient groups. Conclusion Universal screening for hs-CRP may improve assessment and thereby reduce the risk of cardiovascular events.