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Vanderbilt Pathology Laboratory Services

Test Directory



HS-CRP (CRH)

Department: Chemistry
Test Synonym(s): CRH, High Sensitivity CRP, Cardiac CRP, C Reactive Protein
CPT Codes: 86141
Methodology: Particle Enhanced Turbidimetric
Reference Range: HS-Cardiac 18 yrs to 150 yrs: 0-2.9 mg/L; HS-Inflammatory: 0 to14 days: 0.3-6.1 mg/L; 15 days to <15 yrs: 0.1-1 mg/L, 15 yrs to <19 yrs: 0.1-137 mg/L, Adults 19 yrs to 150 yrs: 0-5 mg/L
Tube Type: Light green PST (Lithium Heparin with gel) tube - 4.5 mL
Specimen: Plasma
Alternate Specimen: Red top tube - 5 mL
Volume: 1 mL plasma
Minimum Volume: 0.5 mL plasma
Temperature: Separate within one hour and store at 2-8șC until delivery
Stability: < 3 days at 2 - 8șC; 6 months at -20șC
Reasons for Rejection: Hemolysis; improper collection
Days Performed: Daily
Times Performed: Continuous
Special Instructions: CRP is a non-specific inflammatory marker. Elevations of HS-CRP have been correlated with increased future cardiovascular events, primarily myocardial infarction and stroke. The concentration of HS-CRP can be used to categorize patients for their risk of future cardiovascular disease as follows:


Low risk: <1.0 mg/L


Average risk: 1.0 - 3.0 mg/L


High risk: >3.0 mg/L


Very high risk/Acute Inflammation: >1.0 mg/L


The use of HS-CRP to assess for the risk of cardiovascular disease in asymptomatic low risk (5% 10-year predicted risk) patients is not recommended. HS-CRP may be helpful in stratification of adult patients at intermediate risk (10% - 20% 10-year predicted risk) into a higher or lower risk category. If the concentration of HS-CRP is >3.0 mg/L, repeating test at least 2 weeks later in a metabolically stable state, free of infection or acute illness is recommended.  The lower of the two results should be used to assess the patient's risk.


References:


1. Myers GL, et.al. National Academy of Clinical Biochemistry Laboratory Medicine Practice guidelines: emerging biomarkers for primary prevention of cardiovascular disease. Clin Chem. 2009 Feb;55(2):378-84.


2. U.S. Preventive Services Task Force. Using nontraditional risk factors in coronary heart disease risk assessment: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2009 Oct 6;151(7):474-82.


3. Greenland P, et. al., American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. 2010 ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2010 Dec 21;122(25):e584-636.


4. Lim LS, et. al., ACPM Prevention Practice Committee; American College of Preventive Medicine. Atherosclerotic cardiovascular disease screening in adults: American College Of Preventive Medicine position statement on preventive practice. Am J Prev Med. 2011 Mar;40(3):381.e1-10.

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