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hs-CRP Test (High Sensitivity C-Reactive Protein)
C-reative protein (CRP) is produced by the body during periods of
inflammation. Though not condition specific, it is a significant indicator
of some current health problem. Many things can cause an increase
in CRP (from osteoarthritis, to cancer, to the common cold or other
infection), but in the absence of any specific disease, an increased
CRP level poses a significant risk of heart disease. As a matter of
fact, CRP is the first indicator of heart disease recommended by The
American Heart Association in over 20 years, specifically high
sensitivity C-reactive protein (hs-CRP).
The hs-CRP is most often used to help predict a healthy person’s risk
of cardiovascular disease.
This hs-CRP test adds an important additional piece of information
to your doctor’s traditional assessment of your overall cardiac
health. CRP is produced when the arteries around your heart become
inflamed by atherosclerosis. Even in the absence of traditional
blockages, inflamed artery walls can become softened and develop
weak areas that can suddenly rupture. Plaque also develops more
quickly in inflamed arteries, increasing the risks of heart attack
or stroke.
Healthy men and women with normal cholesterol levels are still
at risk for future heart attack, if they have elevated levels of
hs-CRP. Even people who have hs-CRP results in the high end of the
normal range have 1.5 to 4 times the risk of having a heart attack
as those individuals with CRP values in the lower half.
Note: that post-menopausal women on hormone replacement
therapy will usually have a higher-than-normal CRP level.
For additional graphic detail see:
http://www.clevelandclinic.org/heartcenter/pub/news/hot/crp.asp
What is High Sensitivity C-reactive Protein (HS-CRP)?
(also referred to as ultra-sensitive or US-CRP)
CRP is short for "C-reactive protein," a protein found in
the blood. It is what we call a marker for inflammation, meaning its
presence indicates a heightened state of inflammation in the body.
Inflammation is a normal response to many physical states including
fever, injury and infection. Inflammation is now believed to play
a role in the initiation and progression of cardiovascular disease.
Is HS-CRP a real risk factor, like cholesterol or smoking?
In studies involving large numbers of patients, CRP levels seem to
be correlated with levels of cardiac risk. In fact, CRP seems to be
at least as predictive of cardiac risk as cholesterol levels. Data
from the Physicians Health Study, a clinical trial involving 18,000
apparently healthy physicians, found that elevated levels of CRP were
associated with a threefold increase in the risk of heart attack.
In the Harvard Women's Health Study, results of the CRP test were
more accurate than cholesterol levels in predicting coronary problems.
Twelve different markers of inflammation were studied in healthy,
postmenopausal women. After three years, CRP was the strongest predictor
of risk. Women in the group with the highest CRP levels were more
than four times as likely to have died from coronary disease, or
suffered a nonfatal heart attack or stroke. This group was also
more likely to have required a cardiac procedure such as angioplasty
or bypass surgery than women in the group with the lowest levels.
Elevated hs-CRP is related to increased risk for heart attack,
restenosis of coronary arteries after angioplasty, stroke, and peripheral
vascular disease (PVD).
So how can I be tested?
A simple blood test can be done at the same time as a cholesterol
screening. The high-sensitivity C-reactive protein (hs-CRP) test,
helps determine heart disease risk and is widely available. Patients
should ask their doctors about hs-CRP specifically.
It is important to remember that the usefulness of knowing hs-CRP
levels in a particular individual is still unknown. For the time
being, The
American Heart Association recommends hs-CRP as part of routine
screening for those who are at intermediate risk
for heart disease. HS-CRP results in that risk group can help
the physician determine additional testing and treatment. The American
Heart Association adds that patients at low risk probably do not
need their hs-CRP tested and those at high risk should be treated
agressively regardless of their CRP test results.
Certain medical centers, including The Cleveland Clinic Foundation,
are investigating what the exact role of hs-CRP measurement should
be in a physician's daily clinical practice.
Ultra Sensitive C-Reactive Protein Blood (HS-CRP)
C-reactive protein measures an inflammatory response in the
body. In some cases, inflammation in the arteries may play a
role in heart disease. Research is showing promising results
for testing HS-CRP (along with other risk factors) to determine
heart disease risk in those with undetected heart disease and
risk of complications for those who have already had a heart
event (such as a heart attack).
Results:
• Less than 1.0 mg/L = Low Risk for CVD
• 1.0-2.9 mg/L = Intermediate Risk for CVD
• Greater than 3.0 mg/L High Risk for CVD
Preparation:
This test may be measured any time of the day without fasting.
Should not be used for assessment of acute inflammation. Should
be ordered to evaluate CVD risk in apparently healthy individuals
who have not had recent infection or other serious illness.
Those who have levels of higher than 10 should be evaluated
for other sources of inflammation. |
What can I do if my HS-CRP level is high?
Inflammation
should be treated by lifestyle change, such as losing weight, exercising,
controlling diabetes, stopping smoking, controlling high blood pressure,
and reducing alcohol intake.
Antithrombotic medications such as aspirin or clopidogrel may provide
protection. Cholesterol-lowering statin drugs and ACE inhibitors
may also reduce CRP. Your doctor will prescribe the correct medications
and dosage to treat your condition.
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