Introduction: Inflammation plays a key role in atherosclerotic cardiovascular disease. The relationship between elevated inflammatory markers and major adverse cardiovascular event (MACE) rates in statin-treated high vascular risk patients at different levels of control of conventional risk factors is not well established.Methods: ACCELERATE trial compared the effects of evacetrapib and placebo on MACE rates in 12,092 statin-treated, high cardiovascular risk patients. MACE rates were investigated in patients stratified according to levels of both conventional risk factors and high sensitivity C-reactive protein (hsCRP).Results: Evacetrapib produced greater reductions in LDL-C (-31.1% vs 6%, P<0.001) and triglycerides (-6% vs 0%, P<0.001), a greater elevation in HDL-C (133.2% vs 1.6%, P<0.001), systolic blood pressure (1.2±14.4 mmHg vs. 0±14.3 mmHg, P<0.001) and hsCRP (8.6% vs 0%, <0.001) and smaller increases in HbA1c (2.7% vs 1.9%, P<0.001). An on-treatment hsCRP ≥2mg/L (42% of patients) was more likely to be observed in females (28.1 vs 18.0%, P<0.001), Caucasians (84.4 vs 78.4%, P<0.001), smokers (18.6 vs 14.0%, P<0.001) and a greater BMI (31.1 vs 28.5 kg/m, P<0.001) and associated with greater MACE rates in patients achieving intensive measures of lipids, blood pressure and glycemic control. (Table)Conclusion: The presence of an elevated hsCRP associated with a greater MACE rate in patients achieving more intensive control of conventional risk factors. This suggests that evidence of heightened systemic inflammation continues to promote cardiovascular risk in intensively treated patients.