C-reactive protein: adjunct to cardiovascular risk assessment.

OBJECTIVES

The study aimed to investigate whether elevated plasma high sensitivity C-reactive protein (hs-CRP) levels are independently associated with an increased risk of cardiovascular disease (CVD) and to then assess the effectiveness of the addition of hs-CRP testing to cardiovascular risk assessment by standard lipid screening.

METHODS

A retrospective hospital-based case-control study was designed. All patients attending Cross Crossing Medical Centre (CCMC) for routine cardiovascular assessment or emergency treatment were included. Cases were defined as patients with a cardiovascular event and controls as those without an event. Data collected included blood measurements of hs-CRP and cholesterol, demographic data, drug and risk factor history.

RESULTS

Odds ratio of 1.84 (95% CI 1.00, 3.38) indicated that a patient with elevated hs-CRP is 1.84 times more at risk of CVD than one with normal hs-CRP. Additionally, the association between hs-CRP and CVD was found to be independent of the other risk factors (p = 0.058). Hs-CRP ranked fourth as an indicator of risk above smoking and diabetes, and patients with both high hs-CRP and high cholesterol (OR = 9.5) were 3.5 times more at risk of CVD than someone with high cholesterol alone (OR = 6.0).

CONCLUSIONS

Hs-CRP testing enhanced the clinical identification of patients at risk of cardiovascular events. It can therefore contribute to timely implementation of effective lifestyle modification and pharmaceutical intervention.