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C-reactive protein--a screening test for coronary disease?
1kjkrause@lnc.com
Insights
C-reactive protein (CRP) is an acute phase reactant. Elevated CRP levels, even within normal ranges, can indicate coronary disease risk and predict future cardiovascular events.
Area of Science:
- Biochemistry
- Cardiology
- Inflammation Research
Background:
- C-reactive protein (CRP) is an acute phase reactant indicating inflammation.
- Traditionally used for infectious/inflammatory conditions.
- Emerging role in cardiovascular disease risk assessment.
Purpose of the Study:
- Review research on CRP and cardiovascular/mortality risk.
- Evaluate CRP as a marker for coronary artery disease.
- Outline current applications of CRP in risk assessment.
Main Methods:
- Review of published research on CRP and cardiovascular outcomes.
- Analysis of CRP's predictive value in individuals with and without known coronary artery disease.
- Assessment of sensitive, high-volume CRP assay availability.
Main Results:
- CRP is a valuable predictor of future events in patients with existing coronary artery disease.
- Elevated CRP within conventional "normal" ranges is linked to coronary disease risk.
- Use of CRP as a screening test for healthy individuals is considered premature.
Conclusions:
- CRP is a significant marker for predicting cardiovascular events, especially in those with known disease.
- Further research is needed before widespread use of CRP for screening healthy populations.
- CRP's role in cardiovascular risk assessment is evolving.
Abstract:
C-reactive protein (CRP) is one of a number of substances termed "acute phase reactants," biologic substances that appear in the circulation when an active inflammatory process occurs. Although traditionally used to monitor or detect major infectious or inflammatory conditions, elevations of CRP levels within the conventional range of "normals" has been intensively studied as a marker for coronary disease and risk of future coronary events. Sensitive assays that can be performed on a high-volume, commercial basis are now available. CRP appears to be a valuable marker for the prediction of future events in individuals who have known coronary artery disease. CRP has been proposed as a coronary disease-screening test for healthy individuals; however, available data suggest that use of CRP in this context may be premature. This paper reviews published research concerning CRP and the prediction of cardiovascular and total mortality risk, then outlines the current "state of the art" for the application of CRP to the risk assessment process.