C-Reactive Protein, High Sensitivity, Serum
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
C-reactive protein (CRP) is a biomarker of inflammation. Plasma CRP concentrations increase rapidly and dramatically (100-fold or more) in response to tissue injury or inflammation. High-sensitivity CRP (hs-CRP) is more precise than standard CRP when measuring baseline (ie, normal) concentrations and enables a measure of chronic inflammation.
Atherosclerosis is an inflammatory disease and hs-CRP has been endorsed by multiple guidelines as a biomarker of atherosclerotic cardiovascular disease risk.(European 2011, Goff 2013, Jacobson 2014)
A large prospective clinical trial demonstrated significantly less cardiovascular risk for patients with hs-CRP <2.0 mg/L.(1) More aggressive treatment strategies may be warranted in patients with hs-CRP > or =2.0mg/L.
Assessment of risk of developing myocardial infarction in patients presenting with acute coronary syndromes
Assessment of risk of developing cardiovascular disease or ischemic events in individuals who do not manifest disease at present
Values >2.0 mg/L suggest an increased likelihood of developing cardiovascular disease or ischemic events.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
This test is recommended for cardiovascular risk assessment only.
C-reactive protein (CRP) is an acute-phase reactant and has high intraindividual variability. Therefore, a single test for high-sensitivity CRP (hs-CRP) may not reflect an individual patient's basal hs-CRP level. Repeat measurement may be required to firmly establish an individual's basal hs-CRP concentration. The lowest of the measurements should be used as the predictive value.
Because CRP is an acute-phase reactant, measurements in apparently healthy individuals may not truly reflect the basal level if inflammation is present.
This hs-CRP assay should be used as a means to assess risk of cardiovascular disease or events. A different CRP test (CRP / C-Reactive Protein [CRP], Serum) should be used to monitor or assess other inflammatory disorders.
Significantly decreased CRP values may be obtained from samples taken from patients who have been treated with carboxypenicillins.(Package Insert: Cardiac C-Reactive Protein (Latex) High Sensitive, Roche Diagnostics. Indianapolis, IN. 08/2013)
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
Lower risk: <2.0 mg/L
Higher risk: > or =2.0 mg/L
Acute inflammation: >10.0 mg/L
Clinical References Provides recommendations for further in-depth reading of a clinical nature
1. Ridker PM, Danielson E, Fonseca FA, et al: Reduction in C-reactive protein and LDL-cholesterol and cardiovascular event rates after initiation of rosuvastatin: a prospective study of the JUPITER trial. Lancet 2009;373:1175-1182
2. European Association for Cardiovascular Prevention and Rehabilitation, Reiner Z, Catapano AL, et al: ESC/EAS Guidelines for the management of dyslipidaemias: the Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). Eur Heart J 2011;32:1769-1818
3. Goff DC, Lloyd-Jones DM, Bennett G, et al: 2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk. Circulation 2014;129:S49-S73
4. Jacobson TA, Ito MK, Maki KC, et al: National Lipid Association recommendations for patient-centered management of dyslipidemia: part 1 - executive summary. J Clin Lipidol 2014;8:473-488