Wednesday, June 24, 2009

High Sensitivity C-Reactive Protein (hsCRP)

What do you know about hsCRP (high sensitivity C-Reactive protein, also abbreviated as hs-CRP)? Don't get confused now. hsCRP is not the same as standard CRP. Perhaps you're familiar with the JUPITER study published in the New England Journal of Medicine (NEJM). The conclusion from that study reads: "In this 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."

Here are some interesting facts from the makers of the hsCRP assay:

C-reactive protein (CRP) is an acute phase protein that appears in circulation in response to inflammatory cytokines, such as interleukin-6, and serves as a biomarker for systemic inflammation. Following a systematic review of the association between inflammatory markers and coronary heart disease and stroke, the American Heart Association (AHA) and Centers for Disease Control and Prevention (CDC) developed a scientific statement that recommends hsCRP as a more sensitive assay for the prediction of vascular disease, compared to traditional assays for circulating C-reactive protein levels.

The AHA/CDC Scientific Statement Summary

  • hsCRP is a global indicator of future vascular events in adults without any previous history of cardiovascular disease (CVD), with acceptable precision levels down to or below 0.3 mg/L
  • hsCRP enhances risk assessment and therapeutic outcomes in primary CVD prevention
  • hsCRP is particularly advantageous for assessing the risk in patients with
    • Framingham 10-year risk scores of 10%-20% and/or
    • LDL levels of <160>
  • hsCRP acts as an independent marker for evaluating the possibility of recurrent cardiac events, such as myocardial infarction or restenosis, after percutaneous coronary intervention
AHA/CDC risk assessment guidelines
Low risk <1>
Average risk 1-3 mg/L
High risk >3 mg/L

Do you feel like you're an expert now? Click here to view the abstract for the JUPITER trial in the NEJM.

1 comment:

  1. I think SIP test is a better barometer of internal inflammation prior to acudity for what its worth.