Elevated levels of C-reactive protein (CRP), a marker of systemic inflammation, are associated with an increased risk of developing symptomatic peripheral arterial disease (PAD) in apparently healthy men. A prospective study of 144 men who developed PAD and 144 matched controls found that those who developed PAD had significantly higher baseline CRP levels (median 1.34 mg/L vs. 0.99 mg/L, P=.04). The risk of developing PAD increased with higher CRP quartiles, with the highest quartile showing a 2.1-fold increased risk compared to the lowest (P=.02). Among those requiring revascularization, CRP levels were even higher (median 1.75 mg/L), with a 4.1-fold increased risk in the highest quartile. These findings, adjusted for various risk factors, support the hypothesis that chronic inflammation plays a role in atherothrombosis. The study also found no significant interaction between aspirin use and CRP levels in relation to PAD risk. Overall, these data suggest that CRP levels at baseline predict future risk of developing symptomatic PAD, further supporting the role of inflammation in atherosclerosis.Elevated levels of C-reactive protein (CRP), a marker of systemic inflammation, are associated with an increased risk of developing symptomatic peripheral arterial disease (PAD) in apparently healthy men. A prospective study of 144 men who developed PAD and 144 matched controls found that those who developed PAD had significantly higher baseline CRP levels (median 1.34 mg/L vs. 0.99 mg/L, P=.04). The risk of developing PAD increased with higher CRP quartiles, with the highest quartile showing a 2.1-fold increased risk compared to the lowest (P=.02). Among those requiring revascularization, CRP levels were even higher (median 1.75 mg/L), with a 4.1-fold increased risk in the highest quartile. These findings, adjusted for various risk factors, support the hypothesis that chronic inflammation plays a role in atherothrombosis. The study also found no significant interaction between aspirin use and CRP levels in relation to PAD risk. Overall, these data suggest that CRP levels at baseline predict future risk of developing symptomatic PAD, further supporting the role of inflammation in atherosclerosis.