C-Reactive Protein (CRP)
Test - A Key Indicator of Heart Disease Risk
posted September
7, 2004
Mayo Clinic Cardiologists indicate
CRP is a complement to cholesterol testing and can provide information which
will allow treatment of inflammation of blood vessels of the heart, much
earlier.
In addition to monitoring lipid, or cholesterol, levels, Mayo Clinic
cardiologists have begun ordering a new screening test for heart disease risk,
called high sensitivity C-reactive protein (CRP). CRP, an acute phase protein
made by the liver in response to inflammation, has been found to be elevated in
patients who are developing diseases the blood vessels of the heart (cardiac
atherosclerosis).
An elevated CRP level increases the risk for creating arteriosclerosis and
plaque rupture that causes heart attack.
An elevated CRP level can predict long-term risk for cardiovascular disease,
independent of age, lipid levels, hypertension, diabetes and tobacco use. A
significant number of people who develop heart disease - 10 to 15 percent - have
no identifiable risk factors. Of those, a majority will have an elevated CRP. In
addition to cardiology, the Mayo Clinic Executive Health Program has also begun
screening for CRP levels.
"In cardiology, the future of bringing health care costs down is prevention,"
says Christopher Appleton, M.D., professor of medicine and chair of
Cardiovascular Diseases at Mayo Clinic in Scottsdale. "We are looking to
identify those patients without the obvious risk factors, who still develop
heart disease. An elevated CRP indicating chronic inflammation appears to be a
warning flag even when cholesterol levels appear relatively normal."
Elevated CRP levels are not always related to heart attack risk. CRP may be
temporarily elevated due to an infection or chronically increased in conditions
such as arthritis. Therefore, when a high CRP level is reported, a repeat test
should be taken in another two weeks.
For those with an unexplained elevated CRP, dietary and exercise modifications
can lower the level. In some patients, the presence of an elevated CRP level, in
conjunction with other indicators of cardiovascular disease can guide treatment
in terms of medication, especially cholesterol lowering medicines.
"It's important that people know this indicator exists," says Dr. Appleton.
"Everyone knows about cholesterol and its relationship to heart disease risk.
Coronary artery disease is an inflammatory condition. Therefore, keeping an eye
on both the risk for inflammation and for developing plaque in the arteries is
critical to helping us identify, prevent and treat cardiovascular disease."