CRP to Become Standard of Care for Diagnosing Heart Disease

The level of C-reactive proteins (CRPs) is the single strongest predictor of future cardiovascular disease risk, and diagnostic screening for this marker is expected to become the standard of care for detecting heart disease within the next decade, according to Nader Rifai, Ph.D., associate professor of pathology at Harvard Medical School (Boston, MA, USA). Dr. Rifai discussed CRP screening at the annual meeting of the American Association for Clinical Chemistry (AACC) in Chicago, IL (USA).

Dr. Rifai contends that doctors must abandon the conventional thinking that coronary artery disease is the sole consequence of a mechanical problem, the blockage in the blood flow caused by lipids and leading to an embolism. New research shows that even patients with a small blockage still have embolisms that result in heart attacks. This is caused by plaque build-up and ruptures that contain inflammatory cells, all associated with excessive levels of CRP.

Screened patients with CRP levels in the upper 25 percentile are three times as likely to incur a heart attack as those with lower levels. Fortunately, a number of studies have found that aspirin and statins have been effective in lowering CRP levels. Dr. Rifai believes behavior modification is important in at-risk patients, because CRP levels are not static. They increase due to conditions such as obesity or vitamin B6 deficiency and behaviors such as smoking.

Dr. Rifai says that chemists and laboratory managers should be aware that universal CRP screening is a distinct possibility in the near future. The U.S. Centers for Disease Control (CDC) is actively working with the scientific community to standardize high-sensitivity methods and to develop clinical guidelines for the use of CRP. This essential step will move this marker from medical research to routine clinical practice.




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