A 59-year-old housewife was initially examined 10 years ago because of angina pectoris and essential hypertension. At that time she was found to be moderately obese with blood pressures averaging 165/95 mm Hg and laboratory evidence of hyperlipidemia. The initial electrocardiogram (ECG) revealed nonspecific ST-T wave abnormalities and atrial enlargement. Supporting the diagnosis of atherosclerotic heart disease was a positive thallium exercise stress test. Coronary angiography at that time revealed 2-vessel obstructive disease with high grade lesions in the proximal circumflex artery and 75% occlusion of the first major diagonal branch of the left anterior descending artery. A secondary obtuse marginal branch was completely occluded at its origin with retrograde filling from the distal right coronary artery. The ejection fraction was 45%. The high sensitivity C-reactive protein (hs-CRP) level was 6 mg/dL (normal, 0.03–1.1 mg/dL). The implications of the...

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