Lv Lei, Gluckman Ty J, Strum Matthew, Rajpura Jigar
Novo Nordisk Inc., Plainsboro, NJ, USA.
Center for Cardiovascular Analytics, Research, and Data Science (CARDS), Providence Heart Institute, Portland, OR, USA.
Future Cardiol. 2025 Jul;21(9):701-710. doi: 10.1080/14796678.2025.2514349. Epub 2025 Jun 3.
INTRODUCTION: High-sensitivity C-reactive protein (hsCRP) is a biomarker of systemic inflammation (SI) and its elevated level is considered a risk-enhancing factor for cardiovascular disease in primary prevention. This study aimed to understand opinions of US clinicians using hsCRP testing in the management of patients with atherosclerotic cardiovascular disease (ASCVD) with or without chronic kidney disease (CKD). MATERIALS & METHODS: Clinicians who ordered hsCRP testing with evaluation of patient-level data were surveyed, between June 2023-August 2023. Endpoints included self-identified drivers and barriers to hsCRP testing and assessment of posttest actions following SI recognition. RESULTS: Common factors perceived to prevent hsCRP testing were a lack of evidence showing improvements in patient cardiovascular outcomes after addressing SI in ASCVD and CKD (50%), and lack of proven efficacy of hsCRP testing (33%). Barriers to hsCRP testing included cost, insurance coverage and patient refusal. The most common reason for not considering SI in clinical decision-making was that it would not affect management of ASCVD. After the first hsCRP testing, an average reduction of hsCRP level is observed, but not lower than 2 mg/L. CONCLUSIONS: In this limited study sample, perceived limitations of hsCRP testing included insufficient evidence of improved cardiovascular outcomes in patients with ASCVD.
引言:高敏C反应蛋白(hsCRP)是全身炎症(SI)的生物标志物,其水平升高被认为是一级预防中心血管疾病风险增强因素。本研究旨在了解美国临床医生在管理患有或不患有慢性肾脏病(CKD)的动脉粥样硬化性心血管疾病(ASCVD)患者时使用hsCRP检测的看法。 材料与方法:在2023年6月至2023年8月期间,对那些开具hsCRP检测并评估患者水平数据的临床医生进行了调查。研究终点包括自我认定的hsCRP检测驱动因素和障碍,以及识别SI后对检测后行动的评估。 结果:被认为阻碍hsCRP检测的常见因素包括缺乏证据表明在解决ASCVD和CKD中的SI后患者心血管结局得到改善(50%),以及hsCRP检测缺乏已证实的疗效(33%)。hsCRP检测的障碍包括成本、保险覆盖范围和患者拒绝。在临床决策中不考虑SI的最常见原因是它不会影响ASCVD的管理。首次hsCRP检测后,观察到hsCRP水平平均降低,但不低于2mg/L。 结论:在这个有限的研究样本中,hsCRP检测的感知局限性包括ASCVD患者心血管结局改善的证据不足。
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