Open Access Highly Accessed Research article

C-reactive protein levels in patients at cardiovascular risk: EURIKA study

Julian PJ Halcox12*, Carine Roy3, Florence Tubach34, José R Banegas56, Jean Dallongeville7, Guy De Backer8, Eliseo Guallar109, Ogün Sazova11, Jesús Medina12, Joep Perk13, Philippe Gabriel Steg14154, Fernando Rodríguez-Artalejo5 and Claudio Borghi16

Author Affiliations

1 Wales Heart Research Institute, Cardiff University, Heath Park, Cardiff CF14 4XN, UK

2 Swansea University College of Medicine, Swansea, UK

3 INSERM CIE 801 and Epidemiology and Clinical Research Department, Hôpital Bichat-Claude Bernard, Assistance Publique–Hôpitaux de Paris, Paris, France

4 Université Paris Diderot, Paris, France

5 Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPAZ, Madrid, Spain

6 Centros de Investigación Biomédica en Red (CIBER) of Epidemiology and Public Health (CIBERESP), Madrid, Spain

7 Inserm U744, Institut Pasteur de Lille, Lille, France

8 Department of Public Health, University of Ghent, Ghent, Belgium

9 Departments of Epidemiology and Medicine and Welch Center of Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

10 Department of Cardiovascular Epidemiology and Population Genetics, National Center for Cardiovascular Research, Madrid, Spain

11 AstraZeneca Global Medical Affairs, London, UK

12 Medical Evidence Centre, Global Medical Affairs, AstraZeneca Farmacéutica Spain, Madrid, Spain

13 School of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden

14 Inserm U698, Paris, France

15 Hôpital Bichat-Claude Bernard, Assistance Publique–Hôpitaux de Paris, Paris, France

16 Department of Internal Medicine, Ageing and Clinical Nephrology, University of Bologna, Bologna, Italy

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BMC Cardiovascular Disorders 2014, 14:25  doi:10.1186/1471-2261-14-25

Published: 24 February 2014



Elevated C-reactive protein (CRP) levels are associated with high cardiovascular risk, and might identify patients who could benefit from more carefully adapted risk factor management. We have assessed the prevalence of elevated CRP levels in patients with one or more traditional cardiovascular risk factors.


Data were analysed from the European Study on Cardiovascular Risk Prevention and Management in Usual Daily Practice (EURIKA, Identifier: NCT00882336), which included patients (aged ≥50 years) from 12 European countries with at least one traditional cardiovascular risk factor but no history of cardiovascular disease. Analysis was also carried out on the subset of patients without diabetes mellitus who were not receiving statin therapy.


In the overall population, CRP levels were positively correlated with body mass index and glycated haemoglobin levels, and were negatively correlated with high-density lipoprotein cholesterol levels. CRP levels were also higher in women, those at higher traditionally estimated cardiovascular risk and those with greater numbers of metabolic syndrome markers. Among patients without diabetes mellitus who were not receiving statin therapy, approximately 30% had CRP levels ≥3 mg/L, and approximately 50% had CRP levels ≥2 mg/L, including those at intermediate levels of traditionally estimated cardiovascular risk.


CRP levels are elevated in a large proportion of patients with at least one cardiovascular risk factor, without diabetes mellitus who are not receiving statin therapy, suggesting a higher level of cardiovascular risk than predicted according to conventional risk estimation systems.

Trial registration Identifier: NCT00882336

C-reactive protein; Cardiovascular disease; Epidemiology; Risk factors/global assessment