C-Reactive Protein, High Sensitivity
Why this test?
To assess the risk of developing cardiovascular diseases in practically healthy individuals (along with other markers).
To predict complications (myocardial infarction, stroke, sudden cardiac death) in people with coronary heart disease and hypertension.
To assess the effectiveness of prevention of cardiovascular diseases and their complications.
In what cases is it prescribed?
During a comprehensive examination of practically healthy persons of older age groups.
When examining patients with coronary heart disease, hypertension.
During the treatment and prevention of cardiovascular complications, against the background of taking aspirin (acetylsalicylic acid) and statins in patients with a cardiology profile.
After angioplasty in patients with angina pectoris or acute coronary syndrome (to assess the risk of death, repeated myocardial infarction, restenosis).
After coronary bypass surgery (to detect early postoperative complications).
C-reactive protein is a glycoprotein that is produced by the liver and belongs to the proteins of the acute phase of inflammation. Under the influence of anti-inflammatory cytokines (interleukin-1, tumor necrosis factor - alpha and especially interleukin-6), its synthesis increases after 6 hours, and the concentration in the blood increases 10-100 times within 24-48 hours after the onset of inflammation. The highest levels of CRP (more than 100 mg/l) are observed with bacterial infection. With a viral infection, the level of CRP, as a rule, does not exceed 20 mg / l. The concentration of CRP also increases with tissue necrosis (including myocardial infarction, tumor necrosis).
CRP participates in the activation of complement (a group of proteins that are part of immunity), monocytes, stimulation of the expression of adhesion molecules ICAM-1, VCAM-1, E-selectin on the surface of the endothelium (they ensure the interaction of cells), binding and modification of low-density lipids density (LDL), that is, promotes the development of atherosclerosis. According to the results of recent studies, slow inflammation in the vessel wall plays a major role in the development of atherosclerosis, which, in turn, is associated with the occurrence of cardiovascular diseases. Damage to the vessel wall, inflammation and increase in CRP are contributed by the ""classical"" risk factors of cardiovascular diseases: smoking, obesity, decreased sensitivity of tissues to the action of insulin.
An elevated baseline level of CRP, which can be determined only thanks to highly sensitive analytical methods, reflects the activity of inflammation in the inner lining of blood vessels and is a reliable sign of atherosclerosis. Some studies indicate that patients with elevated CRP and normal LDL have a greater risk of cardiovascular disease than patients with normal CRP and high LDL. Regarding the increased level of CRP, even with a normal level of cholesterol in practically healthy individuals, it is possible to predict the risk of hypertension, myocardial infarction, stroke, sudden cardiac death, type 2 diabetes and obliterating atherosclerosis of peripheral vessels. In patients with coronary heart disease, the excessive content of CRP is a bad sign and indicates a high risk of repeated heart attack, stroke, restenosis during angioplasty and complications after aorto-coronary bypass surgery.
The level of CRP in the blood is reduced by acetylsalicylic acid and statins, which reduce the activity of inflammation in the vessel wall and the progression of atherosclerosis. Regular physical activity, moderation in alcohol consumption, as well as normalization of body weight lead to a decrease in the level of CRP and, accordingly, the risk of vascular complications.
As you know, cardiovascular diseases and their complications rank first among the causes of death among the adult population of developed countries. Studies of the level of CRP in combination with other indicators help to assess the probable risk of developing cardiovascular diseases in relatively healthy people, as well as to predict the course of the disease in patients with a cardiology profile, which can be used for preventive purposes and when planning treatment tactics.