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C-reactive protein (CRP) in serum/plasma high-sensitivity

Indications: American Heart Association & CDC guidelines 1) no general agreement regarding cost-effectiveness 2) optional CRP testing endorsed a) patient with intermediate risk b) marker of prognosis after coronary angiography &/or PTCA c) outcome data using high-sensitivy CRP not available 3) optional CRP testing may be considered a) global risk assessment for adults without known cardiovascular disease b) motivation for patients to improve lifestyle behaviors 4) selection of at risk patients for statin therapy (see Jupiter study)* [4] * Indication(s) controversial Clinical significance: - levels < 1.0 mg/L consistent with low cardiovascular risk - levels > 3.0 mg/L consistent with high cardiovascular risk Procredure: - use average of 2 measurements; 2 weeks apart - a single measurement is appropriate if < 1.0 mg/L [3] Method: - Immunochemiluminometric Assay (ICMA) - method able to detect 0.03 mg/L of CRP

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C-reactive protein (CRP) in serum/plasma

References

  1. Journal Watch 24(1):2, 2004 Pearson TA et al Circulation 107:499, 2003 PMID: 12551878
  2. Journal Watch 23(8):68, 2003
  3. Medical Knowledge Self Assessment Program (MKSAP) 17, American College of Physicians, Philadelphia 2015
  4. Ridker PM, Danielson E, Fonseca FA Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med. 2008 Nov 20;359(21):2195-207 PMID: 18997196