Although our observational study design does not allow for any conclusions regarding mechanisms for the association between hsCRP and plaque morphology characteristics, one could speculate that high hsCRP reflects an increased risk of coronary atherosclerosis through systemic inflammation from adipose tissue, where CRP is a downstream biomarker of IL-6 and other proinflammatory cytokines33, as well as acts as an independent marker for a more vulnerable plaque. Here, CRP is linked to coronary atherosclerosis.