Current ACC (American College of Cardiology) Consensus Recommendations (2025) re HS-CRP

1. In primary prevention (those who have NOT had a heart attack), persistently elevated hsCRP should prompt consideration of statin initiation or intensification, irrespective of LDL-C.
2. In secondary prevention (those known to have heart disease), hsCRP is at least as powerful a predictor of recurrent events as LDL-C.
3. Low-dose colchicine should be considered for patients with chronic stable ischemic heart disease, particularly those with hsCRP >2 mg/L despite aggressive lipid-lowering therapy.

IMPORTANT CAVEAT

No direct anti-inflammatory trial has yet been completed in a purely primary prevention heart disease-free population, though trials of IL-6 inhibitors (ziltivekimab) are anticipated to report in late 2026–2027.

HIGH-LEVEL TAKE HOMES

1. Please know your HS-CRP level.
2. If you already have heart disease and your HS-CRP level is over 2 despite statin therapy, talk to your doctor about colchicine.
3. If you do not have heart disease, and your LDL is normal but your HS-CRP is consistently elevated, talk to your doctor about whether you are a good candidate for statin therapy.