Inflammation and Cardiovascular Risk: A Systematic Review of High-Sensitivity CRP as a Prognostic Indicator

This systematic review evaluates the prognostic role of high-sensitivity CRP (hs-CRP) in predicting cardiovascular outcomes among individuals with type 2 diabetes. Across prospective cohorts spanning varied populations and risk strata, elevated hs-CRP levels consistently signaled heightened susceptibility to major adverse cardiovascular events, vascular mortality, and, in some cases, microvascular complications. Importantly, hs-CRP retained predictive relevance even after controlling for traditional risk indicators such as glycemic status, lipid profiles, and blood pressure, underscoring inflammation as an independent driver of cardiovascular risk in diabetes. Divergent findings in a subset of studies, where hs-CRP more strongly predicted mortality than nonfatal ischemic events, suggest that the biomarker may reflect systemic inflammatory vulnerability and impaired recovery capacity rather than solely plaque burden. The collective evidence supports hs-CRP as a clinically meaningful, biologically plausible indicator of residual risk not captured by conventional models. Incorporating hs-CRP into cardiovascular risk stratification frameworks for diabetic patients may enhance individualized prevention strategies and justify future research on targeted anti-inflammatory interventions. Overall, this review highlights inflammation as a measurable and potentially modifiable determinant of cardiovascular outcomes in diabetes, reinforcing the clinical value of hs-CRP beyond its observational association.