Thanks for the reader's interest in our published manuscript in Cardiology Plus entitled “The relationship between C-reactive protein and cardiovascular events in patients with obstructive and nonobstructive coronary artery disease” and shared their idea about a useful biomarker, high-sensitive C-reactive protein (hs-CRP) in clinical research of cardiovascular medicine. We agree with the author's opinion expressed in the correspondence. At the same time, we have excluded the possibility of these disorders mentioned by readers for our enrolled subjects, presenting carefully in the method section of the manuscript. We have focused on hs-CRP, lipid, and atherosclerosis for more than 20 years. The potential pathogenicity and prognostic role of hs-CRP in different entities of cardiovascular diseases have previously been broadly explored[2–10]. Again, we believe that considering possible background confounding factors is needed when using hs-CRP for cardiovascular research.
Conflict of interest statement
The author declares that there was no conflict of interest with regard to the content of this manuscript.
. Zhang HW, Guo YL, Zhu CG, et al. The relationship between C-reactive protein and cardiovascular events in patients with obstructive and nonobstructive coronary artery disease. Cardiol Plus
2021; 6:166–173. doi: 10.4103/2470-7511.327240.
. Li JJ, Fang CH. C-reactive protein is not only an inflammatory marker but also a direct cause of cardiovascular diseases. Med Hypotheses
2004; 62:499–506. doi:10.1016/j.mehy.2003.12.014.
. Li JJ, Fang CH. Effects of 4 weeks of atorvastatin administration on the antiinflammatory cytokine interleukin-10 in patients with unstable angina. Clin Chem
2005; 51:1735–1738. doi:10.1373/clinchem.2005.049700.
. Li JJ, Zhu CG, Yu B, et al. The role of inflammation in coronary artery calcification. Ageing Res Rev
2007; 6:263–270. doi:10.1016/j.arr.2007.09.001.
. Hu WL, Qiao SB, Li JJ. Decreased C-reactive protein-induced resistin production in human monocytes by simvastatin. Cytokine
2007; 40:201–206. doi:10.1016/j.cyto.2007.09.011.
. Li J, Li JJ, He JG, et al. Atorvastatin decreases C-reactive protein-induced inflammatory response in pulmonary artery smooth muscle cells by inhibiting nuclear factor-kappaB pathway. Cardiovasc Ther
2010; 28:8–14. doi:10.1111/j.1755-5922.2009.00103.x.
. Li JJ, Li S, Zhang Y, et al. Proprotein convertase Subtilisin/Kexin type 9, C-reactive protein, coronary severity, and outcomes in patients with stable coronary artery disease: a prospective observational cohort study. Medicine (Baltimore)
. Cui CJ, Li S, Zhu CG, et al. Enhanced pro-protein convertase Subtilisin/Kexin type 9 expression by C-reactive protein through p38MAPK-HNF1α pathway in HepG2 cells. J Cell Mol Med
2016; 20:2374–2383. doi:10.1111/jcmm.12931.
. Zhang M, Liu SL, Liu HH, et al. Prognostic value of combined C-reactive protein, body mass index, and left ventricular ejection fraction in predicting cardiovascular events in patients ≥80 years of age with acute myocardial infarction. Am J Cardiol
2019; 123:544–548. doi:10.1016/j.amjcard.2018.11.025.
. Liu HH, Li S, Cao YX, et al. Association of triglyceride-rich lipoprotein-cholesterol with recurrent cardiovascular events in statin-treated patients according to different inflammatory status. Atherosclerosis
2021; 330:29–35. doi:10.1016/j.atherosclerosis.2021.06.907.