CRP is a Marker of Inflammation
High specific C-reactive protein (hs-CRP or ultrasensitive CRP) is a protein in blood that is a marker for inflammation. Many recent theories have described the role of inflammation in the development of atherosclerosis (the hardening of the arteries) (1). Numerous major factors can lead to atherosclerosis, such as smoking, high blood pressure, high levels of cholesterol or other lipids, and high glucose levels.
The above factors could increase and stimulate secretion of white blood cells such as monocytes (a type of white blood cell), chemotactic factors and other inflammatory factors. The transformation of monocytes into macrophages and the uptake of cholesterol lipoproteins are thought to initiate the fatty streak.
Crestor (Rosuvastatin) and Jupiter Trial
Summary evidence of 10 good-quality studies suggest that an elevated, high specific CRP predicted a higher coronary heart disease risk. The Jupiter trial (2) results have been published, wherein almost 18,000 apparently healthy people with low density lipoprotein cholesterol (LDL) levels (from less than 130 mg/dL to a high specific CRP >= 2.0 mg/L) were put on rosuvastatin 20 mg/d. In this trial of apparently healthy men and women who did not have hyperlipidemia but did have elevated levels of high sensitivity C-reactive proteins, the rate of the first major cardiovascular event and death from any cause where significantly reduced among the participants who received rosuvastatin as compared with those who received a placebo.
CRP Risk for Cardiovascular Disease
Less than 1.0 mg/L Low
1.0-2.9 mg/L Intermediate
Greater than 3.0 mg/L High
The American Heart Association does not recommend high specific CRP testing as a routine screening for people who are not at high risk for heart disease.
In addition, patients who are already on statins and have been diagnosed with cardiovascular disease, or equivalent conditions such as diabetes mellitus, or peripheral arterial disease, do not need to have their high specific CRP checked. Which patients would benefit from high specific CRP measurements should be evaluated on an individual basis.
- Tracy RP. Inflammation in cardiovascular disease. Circulation. 1998; 97: 2000–2002.
- Ridker PM, Danielson E, Fonseca FA, et al. rosuvastatin to prevent vascular events in men and woman with limited C-reactive protein. N Engl J Med.2008; 359(21): 2195- 2207
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