C-Reactive Protein-hs (high sensitivity) is a plasma protein produced by the liver in response to systemic inflammation as an "acute phase reactant." When coupled with elevated levels of either fibrinogen or Lp-PLA₂, risk for cardiovascular disease progression or events increases.

Clinical Implications:

Elevated hs-CRP levels correlate with the presence of the metabolic syndrome, insulin resistance, endothelial dysfunction, and impaired fibrinolysis. In large epidemiologic studies, elevated levels of CRP have been shown to be a strong indicator of cardiovascular disease. Patients with high CRP (>3.0 mg/L) have a two to four-fold increased risk of developing subsequent atherosclerotic disease compared with patients with low CRP levels.

Treatment considerations:

• Common first-line pharmacological considerations:
  • Statins
• Additional pharmacological considerations:
  • Fibrates
  • Nicotinic acid
  • Aspirin
  • NSAIDS
  • Thiazolidinedones
  • Beta blocking agents
  • Platelet aggregation inhibitors
  • Angiotensin converting enzyme (ACE) inhibitors
  • Angiotensin receptor blockers (ARBs)
  • Cox 2 Inhibitors
• Lifestyle changes:
  • Fat-restricted, cardioprotective diet
  • Weight loss
  • Regular exercise
  • Smoking cessation

For more information and detailed references, please refer to our Clinical Implications Reference Manual.