scholarly journals The Use of High Sensitivity C-Reactive Protein in Cardiovascular Disease Detection

2018 ◽  
Vol 21 ◽  
pp. 496-503 ◽  
Author(s):  
Ana Rita Castro ◽  
Sara Oliveira Silva ◽  
Sandra Clara Soares
Keyword(s):  
Vascular Inflammation ◽  
Life Quality ◽  
High Sensitivity ◽  
Medical Community ◽  
Concentration Limit ◽  
C Reactive Protein ◽  
High Concentration ◽  
Cvd Risk ◽  
Plaque Instability ◽  
Reactive Protein

Cardiovascular diseases (CVDs) are responsible for a high mortality rate worldwide. One of the most common causes of CVDs is vascular inflammation associated to atherosclerosis. Inflammatory biomarkers are used to assist the detection of CVDs and monitor their evaluation, prognosis and therapy implementation. C-reactive protein (CRP) is an acute phase protein produced after stimulation by pro-inflammatory cytokines. CRP is a biomarker of the inflammatory reaction and an important mediator of atherosclerosis. Given it actively contributes to the development of the atherosclerotic plaque, instability and subsequent clot formation it is also considered a CVD risk factor. Since 2010, the plasma concentration of hsCRP (high sensitivity CRP) has been used as a biomarker for disease prognosis in patients with intermediate risk for CVDs. It could be useful to establish a high concentration limit of hsCRP that can be used by clinicians for diagnosis of acute myocardial infarction, cardio embolic or ischemic stroke, and hypertrophic cardiomyopathy. The end cost/effectiveness of hsCRP screening is still an area of controversy but it is a priority to make the medical community aware of the positive relation between high hsCRP and CVDs to improve median survival and life quality of the patients.

scholarly journals Obesity and Metabolic Phenotypes (Metabolically Healthy and Unhealthy Variants) Are Significantly Associated with Prevalence of Elevated C-Reactive Protein and Hepatic Steatosis in a Large Healthy Brazilian Population

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Sameer Shaharyar ◽  
Lara L. Roberson ◽  
Omar Jamal ◽  
Adnan Younus ◽  
Michael J. Blaha ◽  
...  
Keyword(s):  
Hepatic Steatosis ◽  
High Sensitivity ◽  
Abdominal Ultrasound ◽  
Normal Weight ◽  
C Reactive Protein ◽  
Cvd Risk ◽  
Reactive Protein ◽  
Metabolically Healthy Obese ◽  
Metabolically Healthy ◽  
Relationship Of

Background. Among the obese, the so-called metabolically healthy obese (MHO) phenotype is thought to confer a lower CVD risk as compared to obesity with typical associated metabolic changes. The present study aims to determine the relationship of different subtypes of obesity with inflammatory-cardiometabolic abnormalities.Methods. We evaluated 5,519 healthy, Brazilian subjects (43±10years, 78% males), free of known cardiovascular disease. Those with <2 metabolic risk factors (MRF) were considered metabolically healthy, and those with BMI ≥ 25 kg/m2and/or waist circumference meeting NCEP criteria for metabolic syndrome as overweight/obese (OW). High sensitivity C reactive protein (hsCRP) was measured to assess underlying inflammation and hepatic steatosis (HS) was determined via abdominal ultrasound.Results. Overall, 40% of OW individuals were metabolically healthy, and 12% normal-weight had ≥2 MRF. The prevalence of elevated CRP (≥3 mg/dL) and HS in MHO versus normal weight metabolically healthy group was 22% versus 12%, and 40% versus 8% respectively (P<0.001). Both MHO individuals and metabolically unhealthy normal weight (MUNW) phenotypes were associated with elevated hsCRP and HS.Conclusion. Our study suggests that MHO and MUNW phenotypes may not be benign and physicians should strive to treat individuals in these subgroups to reverse these conditions.

Abstract 13654: Gemcabene Monotherapy and in Combination With Atorvastatin Lowers High Sensitivity C-Reactive Protein (hsCRP) in a Phase 2 Clinical Trial

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Evan A Stein ◽  
Rebecca Bakker-Arkenma ◽  
Margaret M McShane ◽  
Mina P Sooch ◽  
Charles L Bisgaier
Keyword(s):  
Vascular Inflammation ◽  
Dose Range ◽  
High Sensitivity ◽  
Lipid Lowering ◽  
Phase 2 ◽  
C Reactive Protein ◽  
Double Blind ◽  
Reactive Protein ◽  
Significant Difference ◽  
Phase 2 Clinical Trial

Background: It is well established that inflammation plays a key role the progression of atherosclerosis and that serum high sensitivity c-reactive protein (hsCRP), may be a good marker of the degree of underlying vascular inflammation. Thus hsCRP has been recognized as a predictor of cardiovascular risk and lipid lowering drugs, such as statins, which also result in a reduction of hsCRP may be more likely to reduce cardiovascular events. Gemcabene is an inhibitor of hepatic cholesterol, triglyceride, and apoC-III synthesis resulting in decreased assembly of VLDL and enhances the systemic clearance of VLDL and its subsequently production of remodeled lipoproteins including LDL. Study Design and Results: In an 8-week double blind randomized, placebo-controlled, dose-ranging, efficacy and safety Phase 2 study, gemcabene 300, 600 and 900 mg/day administered as monotherapy or in combination with atorvastatin 10, 20 and 80 mg/day resulted in a significant and dose dependent reduction of LDL-C (Study 4141001). A secondary objective of this study was to evaluate the modulation of hsCRP by gemcabene. Of 277 patients randomized, 250 (90%) completed the study. Baseline mean LDL-C was 174.7mg/dL, and median hsCRP = 2.5 mg/L. The median % reduction in hsCRP with Gemcabene 300, 600 and 900 mg monotherapy was 25.8%, 41.5% and 35.3% respectively compared with 9.4% for placebo. The rank-transformed data showed significant difference favoring gemcabene over placebo in the 600 and 900 mg groups (p=0.0070 and p =0.0018, respectively). Co-administration of 300, 600, and 900 mg gemcabene with atorvastatin aggregated over the dose range showed decreases in hsCRP beyond atorvastatin monotherapy (which ranged from 27-41%) by an additional 16% (p=0.0237), 23% (p=0.0017) and 28% (p=0.0001), respectively. Conclusions: Gemcabene significantly lowered hsCRP alone and on top of statins in hypercholesterolemic patients.

Thrombospondin-4 polymorphism (A387P) predicts cardiovascular risk in postinfarction patients with high HDL cholesterol and C-reactive protein levels

2011 ◽  
Vol 106 (12) ◽  
pp. 1170-1178 ◽  
Author(s):  
Dan Ryan ◽  
Arthur Moss ◽  
Jeanette McCarthy ◽  
Ilan Goldenberg ◽  
Wojciech Zareba ◽  
...  
Keyword(s):  
Recurrent Events ◽  
Vascular Inflammation ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Matricellular Protein ◽  
Human Populations ◽  
C Reactive Protein ◽  
Cvd Risk ◽  
Reactive Protein ◽  
Thrombospondin 4

SummaryFew studies are available in human populations investigating involvement of vascular inflammation and oxidative stress-related dysfunctional transformation of high-density lipoprotein (HDL) in establishing cardiovascular disease (CVD) risk. To this end, the current work investigated a subgroup of post-infarction patients at high-risk for recurrent events defined by high levels of HDL cholesterol (HDL-C) and concurrently high levels of C-reactive protein (CRP). Thrombospondin-4 (TSP-4), a matricellular protein of vessel walls associated with inflammation, was investigated in terms of CVD risk using multivariable modelling with a well-characterised functional genetic polymorphism of THBS4 (A387P, rs1866389) along with previously demonstrated risk-related functional genetic polymorphisms of CYBA (C242T, rs4673) and CETP (TaqIB, rs708272), and a set of blood markers. Results revealed risk-association for the gain-of-function P-allele of the THBS4 polymorphism (hazard ratio 2.00, 95% confidence interval 1.10–3.65, p=0.024). Additionally, von Willebrand factor was associated with D-dimer levels in the higher-risk P allele patients suggestive of a connection between endothelial dysfunction and thrombogenesis. In conclusion, TSP-4, a matricellular protein involved in regulating vascular inflammation, plays a role in establishing recurrent coronary risk in postinfarction patients with high levels of HDL-C and CRP. Further studies should focus on additional effects of vascular inflammatory processes on anti-atherogenic functionality of HDL particles.

Analytical performance and clinical efficacy for cardiovascular risk estimation of an Olympus immunoturbidimetric high-sensitivity C-reactive protein assay

2006 ◽  
Vol 44 (2) ◽  
Author(s):  
Snežana Jovičić ◽  
Svetlana Ignjatović ◽  
Marijana Dajak ◽  
Nada Majkić-Singh
Keyword(s):  
Cardiovascular Risk ◽  
Clinical Efficacy ◽  
Risk Estimation ◽  
High Sensitivity ◽  
Analytical Performance ◽  
C Reactive Protein ◽  
Cvd Risk ◽  
Reactive Protein ◽  
Deming Regression ◽  
Cardiovascular Risk Estimation

AbstractIncreased C-reactive protein (CRP) concentration within the reference interval (<10.0mg/L) is a strong predictor of cardiovascular disease (CVD) in apparently healthy adults. Cutoff points for use of CRP in estimating CVD risk are <1, 1–3 and >3mg/L for low, average and high relative risk, respectively. For measuring CRP concentrations to assess cardiovascular risk, high-sensitivity CRP (hsCRP) assays have been developed. The aim of this study was to evaluate the analytical performance and clinical efficacy for cardiovascular risk estimation of the Olympus immunoturbidimetric latex CRP assay (sensitive application). The comparative method used was the CardioPhase* hsCRP assay, approved by the Food and Drug Administration for use in CVD risk assessment. The imprecision of the Olympus hsCRP assay in the concentration range 0.2–10.0mg/L was 0.38–8.16% within runs and 3.75–9.63% between runs. For method comparison studies, 194 fresh serum samples were selected to cover the interval 0.15–10.0mg/L CRP. Comparison of the Dade Behring and Olympus methods was performed using weighted Deming regression analysis (slope 0.99mg/L, intercept 0.002mg/L, S

scholarly journals Risk classification in primary prevention of CVD according to QRISK2 and JBS3 ‘heart age’, and prevalence of elevated high-sensitivity C reactive protein in the UK cohort of the EURIKA study

Open Heart ◽  
2018 ◽  
Vol 5 (2) ◽  
pp. e000849 ◽  
Author(s):  
Ieuan Johns ◽  
Konstantinos E Moschonas ◽  
Jesús Medina ◽  
Nicholas Ossei-Gerning ◽  
George Kassianos ◽  
...  
Keyword(s):  
Primary Prevention ◽  
High Sensitivity ◽  
Low Risk ◽  
Chronological Age ◽  
C Reactive Protein ◽  
Cvd Risk ◽  
Treatment Threshold ◽  
Reactive Protein ◽  
Risk Patients ◽  
Heart Age

ObjectivesThis study assessed cardiovascular disease (CVD) risk classification according to QRISK2, JBS3 ‘heart age’ and the prevalence of elevated high-sensitivity C reactive protein (hsCRP) in UK primary prevention patients.MethodThe European Study on Cardiovascular Prevention and Management in Usual Daily Practice (EURIKA) (NCT00882336) was a cross-sectional study conducted in 12 European countries. 673 UK outpatients aged ≥50 years, without clinical CVD but with at least one conventional CVD risk factor, were recruited. 10-year CVD risk was calculated using QRISK2. JBS3 ‘heart age’ and hsCRP level were assessed according to risk category.ResultsQRISK2 and JBS3 heart age was calculated for 285 of the 305 patients free from diabetes mellitus and not receiving a statin. QRISK2 classified 28%, 39% and 33% of patients as low (<10%), intermediate (10% to <20%) and high (≥20%) risk, respectively. Two-thirds of low-risk patients and half of intermediate-risk patients had a heart age ≥5 years and ≥10 years higher than their chronological age, respectively. Half of low-risk patients had hsCRP levels ≥2 mg/L and approximately 40% had levels ≥3 mg/L. Approximately 80% of low-risk patients had both elevated hsCRP and heart age relative to their chronological age.ConclusionsAlmost 40% more patients in this ‘at risk’ group would be eligible for statin therapy following the lowering of the National Institute for Health and Care Excellence treatment threshold to ≥10% 10-year risk. Of patients falling below this treatment threshold, almost all were at increased lifetime risk as measured by JBS3, and of these, the majority had elevated hsCRP levels. These patients with high absolute risk may benefit from early primary CVD prevention.

scholarly journals Evaluation of two new high-sensitivity methods for C-reactive protein

2003 ◽  
Vol 40 (4) ◽  
pp. 398-405 ◽  
Author(s):  
Snjezana Rothkrantz-Kos ◽  
Otto Bekers ◽  
Armand Gubbels ◽  
Marjolein Drent ◽  
Maria P. J. Schmitz ◽  
...  
Keyword(s):  
Blood Donors ◽  
High Sensitivity ◽  
Laboratory Parameter ◽  
Routine Laboratory ◽  
C Reactive Protein ◽  
High Concentration ◽  
Low Concentration ◽  
Reactive Protein ◽  
Hs Crp ◽  
High Concentration Range

Background: The implementation of a high-sensitivity C-reactive protein (hs-CRP) assay as a routine laboratory parameter may be necessary. It would be most practical to use one CRP method giving reliable results for the whole concentration range. We report here the evaluation of two new hs-CRP methods, which cover both the low and the high concentration ranges. Methods: The BN ProSpec hs-CRP (Dade Behring) and Synchron LX 201 PRO hs-CRP methods were compared with the existing hs-CRP IMMAGE1 method (taken as a reference) and, for the high concentration range, also with the routine Synchron LX1 20 CRP method (all from Beckman). Agreement among methods was examined for 521 samples. Reference values were estimated in 291 blood donors. Additionally, the influence of sample turbidity, a major problem of the present Synchron LX20 CRP method, was evaluated. Results: Measurement of CPR by the BN ProSpec was linear down to 0·2 mg/L, whereas the linearity of Synchron LX20 PRO showed some systematic discrepancies. Over the whole measured range (0·2-250 mg/L), precision (coefficient of variation, CV) was ≤3·7% for the BN ProSpec and ≤6·1% for the LX20 PRO. The Synchron LX20 PRO hs-CRP method was found to be superior to the current routine Synchron LX20 CRP method with regard to precision in the low concentration range and the influence of sample turbidity. Both in the low concentration range and especially in the high concentration range, large discrepancies between methods were observed. Conclusion: Although acceptable performance was found for the Synchron LX20 PRO hs-CRP method, overall the performance of the BN ProSpec hs-CRP method was superior. However, standardization among assays needs further improvement in both the low and the high concentration ranges.

Abstract 179: Vascular Inflammation and Hepatic Steatosis among the Overweight Metabolically Healthy Individuals and Normal Weight with Cardiometabolic Risk Factor Clustering

2013 ◽  
Vol 33 (suppl_1) ◽  
Author(s):  
Sameer Shaharyar ◽  
Adil Karim ◽  
Michael J Blaha ◽  
Shozab S Ali ◽  
Omar Jamal ◽  
...  
Keyword(s):  
Hepatic Steatosis ◽  
Vascular Inflammation ◽  
High Sensitivity ◽  
Abdominal Ultrasound ◽  
Normal Weight ◽  
Cvd Risk ◽  
Reactive Protein ◽  
Cardiometabolic Disorders ◽  
Metabolically Healthy ◽  
Hs Crp

BACKGROUND Emerging literature has elucidated a new phenotype, metabolically healthy overweight/obese (MHO) who have a similar CVD risk to normal weight individuals. The aim of the study was to compare the relative risk of both phenotypes with subclinical inflammatory-cardiometabolic disorders. METHODS We evaluated 6,464 healthy non diabetic Brazilian subjects (43±10 years, 79% males). Those with <2 metabolic risk factors (MRF)were considered metabolically healthy and those with BMI≥25 kg/m2 as overweight (OW). High sensitivity C reactive protein (hs-CRP) was measured to assess degree of underlying inflammation and hepatic steatosis (HS) was determined via abdominal ultrasound. RESULTS Overall, 52% OW individuals were metabolically normal, and 11% normal-weight had≥2 MRF. The respective prevalence for elevated CRP (≥ 3 mg/dl) was 28% vs 16%, p<0.0001) and 71% vs 28% for HS, respectively. As compared to those with normal weight/metabolically benign, the highest risk of elevated CRP & HS was noted among those with overweight/metabolically unhealthy individuals (table). Both MHO individuals & normal weight metabolically unhealthy participants had similar association with elevated CRP & HS. CONCLUSION Our study highlights that healthy overweight/obesity & normal weight metabolically unhealthy phenotypes are not entirely benign and efforts are needed to reverse these conditions.

scholarly journals C-Reactive Protein Concentrations Are Very High and More Stable over Time Than the Traditional Vascular Risk Factors Total Cholesterol and Systolic Blood Pressure in an Australian Aboriginal Cohort

2009 ◽  
Vol 55 (2) ◽  
pp. 336-341 ◽  
Author(s):  
Tomer Shemesh ◽  
Kevin G Rowley ◽  
Alicia J Jenkins ◽  
James D Best ◽  
Kerin O'Dea
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Risk Factor ◽  
Systolic Blood Pressure ◽  
High Sensitivity ◽  
C Reactive Protein ◽  
Cvd Risk ◽  
Reactive Protein ◽  
Over Time

AbstractBackground: Stability of circulating high-sensitivity C-reactive protein (hsCRP) concentrations has implications for its utility in assessing cardiovascular disease (CVD) risk. We sought to determine hsCRP reproducibility in an indigenous Australian cohort with a view to use hsCRP as a marker of future CVD in community-based risk-factor screenings.Methods: Seventy people living in a community on the northern coast of Australia participated in 2 risk-factor screenings over a median (interquartile range) follow-up time of 829 (814–1001) days. hsCRP was measured by high-sensitivity nephelometry.Results: Geometric mean hsCRP concentrations at baseline and follow-up were 4.5 and 5.1 mg/L, respectively (P = 0.220), and Pearson product-moment correlation was 0.775. The proportion of people at high CVD risk (hsCRP &gt;3.0 mg/L) at baseline was 67.1% and remained consistently high (68.6%) at follow-up. Linear regression analysis for follow-up hsCRP as a function of baseline hsCRP, sex, and differences in total and regional body fatness showed that baseline hsCRP was the single predictor in the model, accounting for 63.9% of the total variance in follow-up hsCRP (Pmodel &lt; 0.001). Prevalence agreement (95% CI) between baseline and follow-up for the hsCRP &gt;3.0 mg/L category was 84% (73%–92%) (PMcNemar = not significant), and κ coefficient was fair (0.64, compared with 0.31 for systolic blood pressure ≥140 mmHg and 0.43 for total cholesterol ≥5.5 mmol/L).Conclusions: hsCRP concentrations remained consistently reproducible over time across a wide concentration range in an Aboriginal cohort. Correlations between concentrations over time were better than for other traditional CVD risk factors. hsCRP concentration has potential as a marker of future CVD risk.

scholarly journals High Sensitivity C-Reactive Protein Increases the Risk of Carotid Plaque Instability in Male Dyslipidemic Patients

Diagnostics ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 2117
Author(s):  
Manuel Scimeca ◽  
Manuela Montanaro ◽  
Marina Cardellini ◽  
Rita Bonfiglio ◽  
Lucia Anemona ◽  
...  
Keyword(s):  
Carotid Plaque ◽  
Smoking Habit ◽  
Density Lipoprotein ◽  
Heart Association ◽  
High Sensitivity ◽  
C Reactive Protein ◽  
Plaque Instability ◽  
Reactive Protein ◽  
Asymptomatic Patients ◽  
Hs Crp

Background: The aim of this study was to evaluate how the high sensitivity C-reactive protein (hs-CRP) values influence the risk of carotid plaque instability in association with other cardiovascular risk factors. Methods: One hundred and fifty-six carotid plaques from both symptomatic and asymptomatic patients requiring surgical carotid endarterectomy were retrospectively collected. According to the modified American Heart Association, atherosclerosis plaques have been histologically distinguished into unstable and stable. The following anamnestic and hematochemical data were also considered: age, gender, hypertension, diabetes mellitus, smoking habit, therapy, low-density lipoprotein (LDL)-C, kidney failure and hs-CRP. Results: The results of our study clearly show that high levels of hs-CRP significantly increase the carotid plaque instability in dyslipidemic patients. Specifically, a 67% increase of the risk of carotid plaque instability was observed in patients with high LDL-C. Therefore, the highest risk was observed in male dyslipidemic patients 2333 (95% CI 0.73–7.48) and in aged female patients 2713 (95% CI 0.14–53.27). Discussion: These data strongly suggest a biological relationship between the hs-CRP values and the alteration of lipidic metabolism mostly in male patients affected by carotid atherosclerosis. The measurement of hs-CRP might be useful as a potential screening tool in the prevention of atheroscletotic disease.

PP113 High-Sensitivity C-Reactive Protein (hsCRP) Measurements And Burden In Patients With History Of Myocardial Infarction

2017 ◽  
Vol 33 (S1) ◽  
pp. 125-126
Author(s):  
Celine Deschaseaux ◽  
Rumjhum Agrawal ◽  
Anders Gabrielsen ◽  
Ramandeep Jindal
Keyword(s):  
Myocardial Infarction ◽  
Burden Of Illness ◽  
Inflammatory Marker ◽  
Vascular Inflammation ◽  
High Sensitivity ◽  
C Reactive Protein ◽  
Economic Resource ◽  
Reactive Protein ◽  
Search Terms ◽  
History Of

INTRODUCTION:The inflammatory marker C-reactive protein (CRP) can be measured by a high-sensitivity assay (hsCRP) specific to vascular inflammation. We aimed to identify published literature on prevalence of elevated hsCRP and associated clinical, economic, and humanistic burden in patients with a history of myocardial infarction (MI).METHODS:A comprehensive literature search was performed for publications in English between January 2000 and February 2016 in MEDLINE, EMBASE, and MEDLINE In-Process. Search terms were variations on ‘Post myocardial infarction’, ‘CRP’, ‘epidemiology’ and ‘burden’. Clinical and real-world studies reporting baseline CRP levels in patients with a history of MI were included in the analysis.RESULTS:Ten studies (prevalence: two; burden: two; both: six) were included. Cut-off points in hsCRP assays varied from >2 mg/L to ≥5.9 mg/L. Prevalence of hsCRP levels >2, >2.3, ≥2.37 and ≥2.9 mg/L were reported in 36 percent, 49 percent, 50 percent and 33 percent of patients, respectively (one publication each). Two publications reported >3 mg/L levels in 27.6 percent and 53.7 percent of patients. Levels of ≥3.3, ≥3.8, ≥4.2 and ≥5.9 mg/L were found in 38.8 percent, 25 percent, 25 percent and 24.7 percent respectively (one publication each). Of six studies reported CV events, four studies found elevated hsCRP levels to be predictive of future risk. Elevated hsCRP levels independently predicted all-cause mortality in four studies and CV mortality in three studies. Three publications included data on comorbidities: Diabetes was associated with elevated hsCRP in two of three analyses; hypertension in one out of two. No consistent associations between elevated hsCRP levels and hyperlipidaemia (one study), stroke or angina pectoris (one study) were found. No study reported economic, resource use or quality-of-life burden.CONCLUSIONS:Due to limited evidence on prevalence of elevated hsCRP and associated burden of illness in patients with a history of MI, further research is warranted. Variations in findings, cut-off points and methods between studies make generalisations difficult.

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