hs-crp
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Hs-CRP:  Detecting the INFLAMMATION  of Silent Atherosclerosis

Cardiovascular Disease:  A SIGNIFICANT PROBLEM

Cardiovascular disease is the number one killer, claiming more lives each year than all other causes combined.

As many as one-third of all coronary thromboses occur among individuals with no conventional risk factors:

  • Many MIs occur among persons with normal lipid values who otherwise appear to be at low clinical risk
  • Lipid-rich lesions often are responsible for massive MIs

Atherosclerosis, the chief underlying cause of myocardial infarction, is an inflammatory process:

  • The role of the inflammatory process in atherothrombosis has been the subject of over six major prospective studies and the analysis of thousands of patient samples.
  • “Hot Spots” of high temperatures in fatty deposits in coronary artery walls may point to areas that may soon rupture, blocking the artery and causing a heart attack.
  • Inflammation is likely to be a key mechanism in the conversion of a relatively stable atherosclerotic plaque to a weaker one.

Relatively simple interventions can lead to substantial reductions in risk of first MI.

Measurement of novel coronary markers may significantly improve our ability to predict attack risk.

hs-CRP:  Proven AID in the ASSESSMENT of Cardiovascular and Peripheral VASCULAR DISEASE RISK

Dade Behring is pleased to provide the hs-CRP (N High Sensitivity C-Reactive Protein) assay, the first automated routine test that provides the ability to assess cardiovascular disease risk

C-Reactive Protein, an acute phase reactant, has been used for diagnosing and monitoring inflammatory processes. Unlike traditional assays that have limited analytical sensitivity of 5 to 10 mg/L, the new particle-enhanced hs-CRP now enables the routine measurement of CRP concentrations as low as 0.175 mg/L, helping to identify a greater number of patients at risk than less sensitive, older generation assays.

Data from at least 10 studies involving tens of thousands of patients demonstrate that low concentrations of hs-CRP may indicate a silent atherosclerosis six or more years before a cardiovascular event.

Hs-CRP has been proven to enhance cardiac risk assessment independently and in conjunction with lipid markers (see Chart 1).

hs-CRP: a POWERFUL, Independent RISK FACTOR






  

  Numerous prospective 
  studies have demonstrated potent risk assessment sensitivity in both the 
  short- and long-term:



  
    
    
  • 
  
    A higher 14-day mortality was 
  observed in unstable angina or non-Q wave MI.
    • 
    
  • 
  
    In patients showing no coronary 
  artery disease (CAD) by coronary angiography, the measured geometric mean for 
  hs-CRP was 0.87 mg/L. In contrast, the mean hs-CRP concentration was found to 
  be 1.53 mg/L in patients with three affected coronary arteries.
    • 
  



  

  Baseline hs-CRP concentrations >2.1 mg/L were associated with:
    
  
  • 
  
    
    A 2.9-fold increase in risk of first MI (P<0.001).
    • 
  
  • 
  
    
    A 1.9-fold increase of ischemic stroke (P=0.02).
    • 
  
  • 
  
    
    A 4.1-fold elevation of risk of developing severe peripheral arterial 
    disease (P=0.03).
    • 


  
Compared 
  to women with low levels of hs-CRP, women with high levels have a five-fold 
  increase in the risk of any vascular event and an eight-fold risk of MI or 
  stroke.

  For each standard 
  deviation increase in hs-CRP, an overall 19% increase in future coronary heart 
  disease was observed.

  Smokers had significantly higher median concentrations of hs-CRP than 
  nonsmokers (P<0.001); however, the long-term effects of the concentration of 
  his-CRP on the risk of MI were virtually identical in both groups.
The 
  relative risk of future MI among non-smokers increases significantly with each 
  increasing quartile of hs-CRP.
The 
  relationship between the concentration of hs-CRP and myocardial infarction was 
  not significantly altered in analysis that adjusted for:

  
    
    
  • 
  
    Body-mass index
    • 
    
  • 
  
    Presence of / absence of diabetes
    • 
    
  • 
  
    Hypertension
    • 
    
  • 
  
    Family history of premature 
  coronary artery disease
    • 
    
  • 
  
    Plasma concentrations of :
      
      
    • 
  
      Total cholesterol
      • 
      
    • 
  
      HDL cholesterol
      • 
      
    • 
  
      Triglycerides
      • 
      
    • 
  
      D-dimer
      • 
      
    • 
  
      Fibrinogen
      • 
      
    • 
  
      Homocysteine
      • 
      
    • 
  
      Paraproteins
      • 
      
    • 
  
      Rheumatoid factors
      • 
    
    
    
    • 
  



  

  hs-CRP:  
  ENHANCING the Predictive VALUE of Lipids

hs-CRP and Total Cholesterol improved prediction of risk compared to TC 
    alone (P=0.003) (see Chart 2).

    Adding hs-CRP significantly improved prediction compared to TC:HDL-C ratio 
    (P=0.002) or TC and HDL-C separately (P=0.002)(see Chart 3).

  For More 
  Information:

    
Contact the Laboratory Department

Test Ordering:

    hs-CRP

 

 Chart 1 

Chart 2   

 Chart 3