What Is C Reactive Protein Cardiac

How Is The Test Used

C-Reactive Protein: Testing for Heart Disease

A high-sensitivity C-reactive protein test measures low levels of CRP and may be used to help evaluate an individual for risk of cardiovascular disease . It may be used in combination with a lipid panel or with other cardiac risk markers, such as a lipoprotein-associated phospholipase A2 test, to provide added information about heart disease risk.

High-sensitivity CRP is thought by some experts to be a useful test for determining risk of CVD, heart attacks, and strokes and that hs-CRP can play a role in the evaluation process before a person develops one of these health problems. Some say that the best way to predict risk is to combine a good marker for inflammation, like hs-CRP, with the lipid panel. Several groups have recommended that this test be used for people who have a moderate risk of heart attack over the next 10 years.

However, not all health professionals agree on hs-CRPs usefulness. Clinical trials that involve measuring hs-CRP levels are currently underway in an effort to better understand its role in cardiovascular events. These studies will help to form and refine guidelines on its use in screening and treatment decisions.

What Is Crp Test

C-reactive protein test is also called CRP test, is a general blood test that checks for infection or inflammation in the body. C-reactive protein test is used to determine the severity of inflammation and to monitor whether you are responding to treatment. C-reactive protein is an acute phase reactant, a protein made by the liver and released into the blood within a few hours after tissue injury, the start of an infection, or other cause of inflammation as well as following a heart attack, surgery, or trauma. Markedly increased C-reactive protein levels are observed, for example, after trauma or a heart attack , with active or uncontrolled autoimmune disorders, and with serious bacterial infections like sepsis. The level of CRP can jump as much as a thousand-fold in response to inflammatory conditions, and its rise in the blood can precede pain, fever, or other clinical indicators. Thus, C-reactive protein is one of several proteins that are often referred to as acute phase reactants. The C-reactive protein test measures the amount of CRP in the blood and can be valuable in detecting inflammation due to acute conditions or in monitoring disease activity in chronic conditions. However, CRP blood test does not show where the inflammation is in your body. A more sensitive form of the C-reactive protein test is called the high-sensitivity C-reactive protein , that is used to assess your risk of heart disease.

Key points

What is a normal C-reactive protein level?

Drawbacks Of Crp Tests

Measuring CRP levels is not a perfect method for diagnosing RA or determining the effectiveness of a treatment. This is because CRP is not specific to RA. Elevated levels of CRP can indicate any type of infection or inflammatory condition.

On the other hand, some people with RA may have normal CRP levels. A study published in 2009 looked at databases of patients living with RA in Finland , and the United States over a period of 25 years.

Results showed that 44 to 58 percent of the patients, living in Finland and the United States, respectively, had normal CRP test results.

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Why Do I Need A Crp Test

You may need this test if you have symptoms of a serious bacterial infection. Symptoms include:

If you’ve already been diagnosed with an infection or have a chronic disease, this test may be used to monitor your treatment. CRP levels rise and fall depending on how much inflammation you have. If your CRP levels go down, it’s a sign that your treatment for inflammation is working.

Symptoms Of A Heart Attack Can Include:

Frontiers
  • chest pain – a sensation of pressure, heaviness, tightness or squeezing across the chest
  • pain in other parts of the body – it can feel as if the pain is spreading from your chest to your arms , jaw, neck, back and abdomen
  • feeling lightheaded or dizzy
  • feeling sick or being sick
  • an overwhelming sense of anxiety
  • coughing or wheezing
  • Although the chest pain is often severe, some people may only experience minor pain, similar to indigestion. While the most common symptom of a heart attack in both men and women is chest pain, women are more likely to experience other symptoms such as shortness of breath, nausea/vomiting and back or jaw pain

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What Are The Causes Of Elevated C

Elevated CRP can signal many different conditions, including cancer, cardiovascular disease, infection, and autoimmune conditions such as rheumatoid arthritis, lupus, and inflammatory bowel disease. The chronic inflammation behind an elevated CRP level may also be influenced by genetics, a sedentary lifestyle, too much stress, and exposure to environmental toxins such as secondhand tobacco smoke. Diet has a huge impact, particularly one that contains a lot of refined, processed and manufactured foods.

Therapy For High Levels Of Crp

Knowing that CRP is involved in CVD pathophysiology, it is expected that reduction of CRP levels prevents the development of the disorder and its complications. Data suggests that certain drugs can reduce CRP levels, however, the clinical relevance of these interventions is not known .

Prevention of cardiovascular events in individuals with high CRP levels can be achieved using CRP lowering agents. Table 2 summarizes the main studied agents/strategies that contribute to reduction of plasma CRP.

Table 2: CRP lowering agents. View Table 2

Aspirin has the capacity of reducing the risk offuture cardiovascular events due to its antiplatelet and anti-inflammatory properties . In 1997, Ridker and collaborators published the first study that demonstrated the effect on reduction of cardiovascular events, because of therapy with acetylsalicylic acid, together with serum CRP levels reduction . This study showed that a dose of aspirin per day contributes to a 44% decrease in myocardial infarction risk. Patients having higher CRP levels showed higher risk decrease . In the same way, a 75 mg per day dosage during a month led to a meaningful reduction in plasma CRP . On the other hand, other studies demonstrated the ineffectiveness of aspirin relative to CRP levels . Cyclooxygenase-2 Inhibitors were also tested for their ability to reduce CRP levels. Some studies observed a decrease on serum CRP levels, when used alone or in combination with statins or aspirin .

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How Does Crp Relate To Cardiovascular Risk

Your level of C-reactive protein can be an indicator of how at risk you are for developing cardiovascular problems. This is because the development of atherosclerosis is associated with inflammation within the vessel walls. The result is higher levels of CRP in patients with atherosclerosis than in those without atherosclerosis.

The value of knowing CRP levels depends on whether you fall into one of three cardiovascular risk groups:

  • Low risk because of low cholesterol levels and little history of risk factors that is, no diabetes, high blood pressure, or smoking, and no family history of heart attacks at an early age. Even a higher level of CRP will probably not put you at a level of risk that requires than lifestyle changes.
  • Intermediate risk helpful to know CRP level, because it can provide missing piece of information for physician deciding next step in treatment
  • High risk not essential to know your CRP, because you should already be combining aggressive treatment with lifestyle changes to lower your risk

What Does It Mean If Your C Reactive Protein Is High

C Reactive Protein
C-reactive protein is a protein that your body produces in response to inflammation. Inflammation can be caused by many things, such as infection, injuries, or smoking.

What does it mean if your C reactive protein is high?

C-reactive protein is a biomarker that is used to measure the amount of inflammation in the body. Elevated levels of CRP indicate that there is inflammation somewhere in the body.

There are many conditions and diseases that can cause inflammation, including infection, autoimmune disorders, cancer, and heart disease. So, if your CRP levels are high, it could be an indication of any number of health problems. It’s important to get checked out by a doctor to determine the root cause of the inflammation.

High C-reactive protein levels indicate that you have inflammation somewhere in your body. This could be due to an infection, autoimmune disease, or any other type of inflammatory condition. It’s important to determine the cause of the inflammation so that you can address it and hopefully improve your health.

C-reactive protein is a protein that your body produces in response to inflammation. Inflammation can be caused by many things, such as infection, injuries, or smoking. When CRP levels are high, it means that you have a lot of inflammation in your body.

A high C reactive protein level is a sign that you have inflammation in your body. Inflammation is linked with many health conditions, including heart disease, cancer, and Alzheimer’s disease.

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Crp In Primary Prevention

Due to the relationship between high CRP plasma levels and cardiovascular mortality and morbidity risk , it is important to establish a primary care line to decrease CVDs. For this, it is essential the evaluation of cardiovascular risk factors to stop their progression.

Several prospective studies having CRP as central target, have shown the benefits of primary prevention. In 1999, the MONICA-Augsburg study performed in a sample of 936 asymptomatic men, concluded that the increase of hs-CRP leads to a 19% increased risk of fatal and non-fatal coronary events.

In the same way, the PREVEND study in 8139 asymptomatic men and women observed a relationship between hs-CRP and angiographic characteristics and consequently clinical instability of the atherosclerotic plaque . The use of lovastatin in the treatment of 5742 individuals reduced the occurrence of the first coronary event both in individuals with high cholesterol levels, and in the ones having high hs-CRP levels, even with low lipid profile .

The PRINCE study performed with 1702 asymptomatic men and women showed that pravastatin reduces hs-CRP levels in individuals without previous history of CVD, independently of cholesterol levels.

Rosuvastatin was tested in 1802 asymptomatic men and women in the JUPITER study . It was observed a reduction of 50% in LDL levels and 37% in hs-CRP levels, consequently reducing cardiovascular events in these apparently healthy individuals.

What Is The Difference Between Regular Crp And Hs

Both tests measure the same protein in the blood. The hs-CRP test is for apparently healthy people to determine their risk of cardiovascular disease. It measures CRP in the range from 0.5 to 10 mg/L. The CRP test is ordered to evaluate people who have signs and symptoms of a serious bacterial infection or of a serious chronic inflammatory disease such as rheumatoid arthritis. It measures CRP in the range from 10 to 1000 mg/L.

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Biochemical And Analytical Issues

C-reactive protein is a non-specific first-line host defence mechanism. With stimulation by cytokines , C-reactive protein synthesis in hepatocytes occurs within 46 h. Concentrations can rise 1000-fold or more over 2448 h. C-reactive protein has been detected in atherosclerotic plaques its possible role in atherosclerogenesis is summarized in Figure , but is still a matter of debate. Genetic variants account for 3540% of the variability in high-sensitivity C-reactive protein.

Possible pathophysiological effects of C-reactive protein in atherosclerosis. Aggregated C-reactive protein selectively binds LDL and VLDL in serum, thereby potentially participating in the mechanisms involved in plaque formation and destabilization, and shows some of the key properties of antibodies and may contribute to immune responses by activation of antigen presenting cells. Procoagulant effects have been reported in vitro as well. C-reactive protein induces increased expression of adhesion molecules and modulation of NO synthesis. Dashed arrow represents weak evidence, whereas continuous arrow denotes evidence confirmed by several studies. APC, antigen presenting cell CRP, C-reactive protein LDL, low-density lipoprotein NO, nitric oxide VLDL, very low-density lipoprotein TF, tissue factor.

Youll Likely Get This Blood Test If Your Doctor Suspects You Have An Autoimmune Inflammatory Disease

Measuring Your C Reactive Protein Levels

Theres no single test that can give a definitive diagnosis for rheumatoid arthritis and other autoimmune arthritis. In addition to blood tests that measure inflammation, such as the CRP test, and antibodies, rheumatologists look at factors like physical symptoms and imaging, such as X-rays and MRIs. Doctors put these factors together to make a clinical diagnosis, which means they look at the big picture of the disease, rather than a relying on a single test result.

The C-reactive protein test is one of many blood tests your doctor might order for to help make your diagnosis and throughout your treatment. Heres what the CRP blood test can and cant reveal about your condition.

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Study Design And Participants

Details of the objectives, design, and methods of HPS have been previously reported, and are summarised in this Article. Between 1994 and 1997, 20536 men and women aged 4080 years at high risk of vascular events were recruited from 69 UK hospitals. Participants had to have a previous diagnosis of coronary disease, occlusive disease of non-coronary arteries, diabetes , or, for men 65 years and older, be receiving drug treatment for hypertension. The exclusion criteria are listed in the study protocol. Ethics approval was obtained from relevant authorities.

At the initial screening visit, nurses recorded information about past medical history and other relevant factors measured the patient’s height, weight, and blood pressure and took a non-fasting blood sample. Potentially eligible patients were given information about the study and asked for their written agreement to participate. Consenting participants entered a run-in phase, consisting of 4 weeks of placebo followed by 46 weeks of 40 mg simvastatin daily. Compliant individuals who did not have a major problem during the run-in and remained eligible were then randomised into the study and had their current medication recorded.

Crp And Type 2 Diabetes Mellitus

Type 2 diabetes mellitus is a serious disease associated with high morbidity and mortality. CRP, tumor necrosis factor-alpha, and IL-6 may be triggered by the excessive adipose tissue to activate insulin signaling pathways, resulting in insulin resistance that eventually progresses into T2DM . Cross-sectional and prospective studies have demonstrated a relationship between elevated CRP levels and increased risk for T2DM . Higher levels of hemoglobin A1c , the indicator of overall glycemic control in diabetics, were positively correlated with elevated CRP levels even after adjustment, as seen in elderly patients with T2DM . In comparison to subjects with normal fasting glucose, patients with diabetes and impaired fasting glucose level showed a strong increase in hs-CRP . Furthermore, clinical studies showed elevated serum concentrations of fetuin-A, vascular endothelial growth factor, and CRP in T2DM patients with diabetic retinopathy , suggestive of the increased risk of DR with high CRP level .

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What Elevated Crp Levels Mean

When CRP levels remain elevated for a long time, it can be an indication that chronic inflammation of the blood vessels is present.

This type of low-grade inflammation contributes to the deposit of fat and other substances in the artery walls, a condition called atherosclerosis.

This build-up can narrow the arteries that feed the heart blood, causing coronary artery disease . Over time, heart attack, stroke, or heart failure can occur.

This is true even for those with elevated CRP levels who have no obvious signs of active inflammation.

It is now well-established that inflammation is an important contributor to atherosclerosis. Elevated CRP is also firmly associated with an increased risk of CAD.

What is not known is whether CRP itself actually contributes to CAD directly.

What Should You Do If You Have High Crp

C Reactive Protein

Lowering your CRP isnt a guaranteed way to lower your risk of cardiovascular or autoimmune disease.

Its important to know that high CRP is what doctors call a biomarker. A biomarker is a factor to keep in mind when analyzing a persons health, but not a stand-alone indicator of a particular diagnosis.

A 2015 study indicates that eating a nutritious, balanced diet including lots of fruits, vegetables, and fiber may help lower your CRP concentration.

If youre at high risk of cardiovascular disease and your test results show high CRP, your doctor may suggest a statin or other cholesterol-lowering medication.

Vitamin C has also been explored as a way to lower CRP levels for people who have an elevated risk of cardiovascular disease.

A suggests that probiotics may also have a positive effect in lowering CRP.

However, more studies have to be done for each method before any definitive claims can be made.

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When Should You Have C

Checking the CRP level for the entire adult population is not recommended. Some experts recommend checking the serum CRP level routinely along with the cholesterol level however, although this is not widely accepted. Ideally, for cardiac risk testing, it is advisable to use the average between two separate CRP levels drawn two weeks part.

More importantly, the CRP level can provide additional information about an individual’s cardiovascular risk in conjunction with other known cardiac risk factors, such as,

  • exercise, and
  • cholesterol-lowering medication.

People with elevated C-reactive protein levels may be advised by their treating doctors. Statin drugs are at the forefront of the recommended cholesterol-lowering agents. Lowering of CRP may be seen with the use of statin drugs even without significant improvement of the cholesterol profile.

Reduction of CRP level has also been noted in individuals with known cardiovascular disease who begin aspirin therapy. In those without known cardiovascular disease or significant risk factors for it, aspirin use is not generally recommended. Some diabetic medications have also been shown to reduce CRP levels in people with or without diabetes mellitus. This effect was seen independent of their glucose-lowering effects.

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