Cardiac related
High sensitivity C-reactive protein (hsCRP)

Revised: 31 December 2018, last major update December 2010

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PubMed Search: High sensitivity C-reactive protein [title]

Larry Bernstein, M.D.
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Cite this page: Bernstein L. High sensitivity CRP (hsCRP). website. Accessed September 19th, 2019.
Definition / general
  • hsCRP is an enhanced sensitivity C-reactive protein (CRP) immunoassay with a lowered measurement cutoff
  • Laser nephelometry

  • In the JUPITER trial of apparently healthy persons without hyperlipidemia but with elevated high-sensitivity C-reactive protein levels, rosuvastatin significantly reduced the incidence of major cardiovascular events (N Engl J Med 2008;359:2195)
  • This effect is thought to be due to the effect of statins on inflammation, which is detected by hsCRP
  • hsCRP assessment for cardiovascular disease in asymptomatic individuals seems to be most useful for those classified as intermediate risk on the basis of traditional risk factors (e.g. an NCEP-ATP III global risk score between 5% and 20%), and who do not already warrant chronic treatment with aspirin and a statin

  • Most useful for patients with intermediate risk for cardiovascular disease (Circ Cardiovasc Qual Outcomes 2008;1:92, Ann Intern Med 2009;151:483)
  • For low risk patients, if their risk increases 3x (e.g. from 1% to 3%), their absolute cardiovascular risk is still low, so the hsCRP test has no practical value
  • High risk patients are candidates for chronic aspirin and lipid-lowering therapy regardless of their hsCRP test results
  • However, a recent study concludes that risk based statin treatment without hs-CRP testing is more cost-effective than hs-CRP screening, assuming that statins have good long-term safety and provide benefits among low-risk people with normal hs-CRP (Circulation 2010;122:1478)

Reference ranges
  • Low risk: under 1 mg/L
  • Intermediate risk: 1-3 mg/L
  • High risk: > 3 mg/L
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