Clinical and Interpretive

This assay can be used to aid in the assessment of risk of developing myocardial infarction in patients presenting with acute coronary syndromes and in the assessment of risk of developing cardiovascular disease or ischemic events in individuals who do not manifest disease at present.

C-reactive protein (CRP) is 1 of the most sensitive acute-phase reactants. Plasma CRP levels can increase dramatically (100-fold or more) after severe trauma, bacterial infection, inflammation, surgery, or neoplastic proliferation. Measurement of CRP has been used historically to assess activity of inflammatory disease, to detect infections after surgery, to detect transplant rejection, and to monitor these inflammatory processes. While assays for CRP have been available for many years, the traditional assays lack the sensitivity to measure basal levels of CRP.

In the mid-1990s, more sensitive methods for measurement of CRP were introduced. These methods, referred to as high sensitivity CRP (hs-CRP), can accurately measure basal levels of CRP throughout the currently accepted cardiovascular risk assessment range (0.20-10.0 mg/L).

These hs-CRP assays were used to assess outcomes in patients with unstable angina and showed that hs-CRP values in the upper tertile (>3.0 mg/L) were associated with increased risk of developing myocardial infarction. Data from prospective studies monitoring hs-CRP in apparently healthy populations also have been published. All prospective studies reported to date have been positive, with adjusted relative risks of developing cardiovascular disease or ischemic events ranging from 2.3 to 4.8 in the highest quartile or quintile of data versus the lowest quartile or quintile. It also has been shown that hs-CRP is additive with total cholesterol, low-density lipoprotein cholesterol (LDL), and high-density lipoprotein cholesterol (HDL), as well as the Framingham 10-year risk score, with respect to risk prediction.

More aggressive treatment strategies may be pursued in patients determined to be at increased risk by hs-CRP values.

Increased high sensitivity C-reactive protein values are associated with increased risks of cardiovascular disease or cardiovascular events.

This test is recommended for cardiovascular risk assessment only.

C-reactive protein (CRP) is an acute-phase reactant. 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.