Brief review and critical examination of the use of hs-CRP for cardiac risk assessment with the conclusion that it is premature to use this test.
BACKGROUND
Inflammation appears to be an important ingredient in the process of atherosclerosis that leads to coronary artery disease. Some have designed an algorithm for assessing risk of coronary artery disease using the inflammatory marker hs-CRP in conjunction with lipoprotein lipid risk factors.


OBJECTIVE
I contend that because of its poor discrimination for coronary risk in clinical trials, until its utility is better proven, hs-CRP should not be recommended for defining risk.


METHODS
Published articles and reassessment of papers previously published.


CONCLUSIONS
After adjustment for conventional risk factors, hs-CRP discriminates poorly between persons with coronary disease and those without over a range of from about 0.6 to 7 mg/L which includes most apparently well people. Nor does the evidence indicate that hs-CRP adds significant predictive value to the clinical traits that define metabolic syndrome.
Levinson
Stanley S
SS
Laboratory Service, Department of Veterans Affairs Medical Center, 800 Zorn Avenue, Louisville, KY 40206, USA. levinson@louisville.edu
D002097:C-Reactive Protein / Q000032:analysis*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003327:Coronary Disease / Q000097:blood / Q000175:diagnosis*; D006801:Humans; D011237:Predictive Value of Tests; D018570:Risk Assessment
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D002097:C-Reactive Protein