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.