Chemistry, toxicology & urinalysis
Organ specific
Cardiac
High sensitivity CRP
Author: Larry Bernstein, M.D.
Last author update: 10 December 2010
Last staff update: 30 September 2020
Copyright: 2003-2024, PathologyOutlines.com, Inc.
PubMed Search: High sensitivity C-reactive protein [title]
Cite this page: Bernstein L. High sensitivity CRP. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/chemistrycardiachscrp.html. Accessed April 24th, 2024.
Definition / general
- hsCRP is an enhanced sensitivity C-reactive protein (CRP) immunoassay with a lowered measurement cutoff
Laboratory
Methodology
Indications
Limitations
Reference ranges
- Laser nephelometry
Indications
- 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
Limitations
- 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
Additional references
