Re: CRP Question

[Guest guest]

Jody: I'm not familiar with CRP in children.

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New Heart Disease Blood Test Discouraged

Experts Recommend Narrow Use for CRP Test

By Peggy Peck

WebMD Medical News Reviewed By , MD

on Monday, January 27, 2003

> Email to a friend > Printer-friendly version

Jan. 27, 2003 -- For those thinking about asking for the new heart disease

blood test -- the one that has appeared on front pages and TV news magazines --

here are a few words from the experts: Not so fast.

This latest one-stop-shopping approach to heart disease risk, actually a

blood test that measures a substance called C-reactive protein (CRP), is not for

everyone, according to new recommendations from the American Heart Association

and the CDC.

In a series of recommendations released today and published in the Jan. 28

issue of Circulation: Journal of the American Heart Association, a blue-ribbon

panel of heart experts reports that although elevated C-reactive protein is a

risk factor for heart disease, it is not in the same category as cholesterol or

high blood pressure.

A. Pearson, MD, PhD, who co-chaired the AHA/CDC Writing Group that

crafted the new recommendations, tells WebMD there is no need for CRP screening

of the entire adult population.

That differs from AHA advice on cholesterol and blood pressure -- all

adults should know those numbers, says Pearson.

The new blood test is called a highly sensitive CRP test or hs-CRP for

short. CRP is a sign of inflammation and is found in the blood. As inflammation

in the body rises -- for example, in response to an infection -- so do CRP

levels.

But in recent years, several studies have indicated that heart disease --

even in its earliest stages -- also triggers inflammation. In addition, these

studies showed that high CRP levels are seen in people with heart disease.

Pearson says the AHA and CDC issued the new recommendations because the

blood test has received a great deal of publicity, which has led to widespread

public demand for testing. For example, he says that 130,000 of the new blood

tests were obtained during 2001, even though there was very little scientific

evidence to support widespread use of the test.

Pearson says that based on the current evidence, hs-CRP is most useful

when a doctor is " sitting on the fence " while determining the right treatment

strategy for a person with intermediate risk of heart disease. In those cases --

meaning someone who, based on cholesterol, blood pressure, smoking history, and

weight, is believed to have about 10% to 20% increased risk for heart attack

over the next 10 years -- an elevated hs-CRP could tip the scale toward more

aggressive treatment.

A. Mensah, MD, co-chair of the Writing Group and chief of the

cardiovascular health program at the CDC, says hs-CRP should not be used to

guide treatment because there is " no evidence that making a treatment decision

based on CRP improves survival or reduces complications. "

The doctor who has been most closely associated with hs-CRP is

Ridker, MD of the Center for Cardiovascular Disease Prevention and the Divisions

of Cardiology and Preventive Medicine, Brigham and Women's Hospital and Harvard

Medical School, Boston. Ridker tells WebMD that while the recommendations are

" appropriately conservative " he considers the overall statement positive since

it is the first time " in 25 or 30 years -- the first time since cholesterol --

that the AHA/CDC are recommending that a new biomarker be measured. "

Ridker says that he is, however, inclined to suggest that hs-CRP may play

a wider role in primary prevention.

In addition to serving as the lead investigator on most of the current

hs-CRP studies, Ridker is the co-owner of hs-CRP use patents, which means that

he receives a " very small " amount of income from hs-CRP tests. " I get 8% of the

very small amount of money that comes to the Brigham from hs-CRP tests. " Costs

for hs-CRP vary but generally the test costs about $20.

In an editorial that accompanies the new AHA/CDC recommendations, Dean J.

Kereiakes, MD, of the Carl and Edyth Lindner Center for Research and Education

Ohio Heart Health Center, Cincinnati, writes that he and other heart specialists

are still waiting for studies that will not only explain how to lower CRP but

also prove that if patients can lower their CRP they can lower their risk for

heart attack in the same way that lowering blood pressure or cholesterol lowers

risk.

--------------------------------------------------------------------------

SOURCES: Circulation, Jan. 28, 2003 . A. Pearson, MD, PhD,

co-chair, AHA/CDC Writing Group . Ridker, MD, Center for Cardiovascular

Disease Prevention and the Divisions of Cardiology and Preventive Medicine,

Brigham and Women's Hospital and Harvard Medical School, Boston.

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Re: Cont'd Iodine Patch Thread

I was just wondering if anyone knows what is a " good " CRP score.

At what point does the CRP show that there is a problem?

Thanks!

Jody

[Guest guest]

Jody: I'm not familiar with CRP in children.

I had read quite a few pages with information like you just

posted, but I couldn't find any informatino on the CRP being used

with " our " kids.

The message you had posted from Bill H indicated that he used

the CRP readings. Just curious as to how they are used.

Thanks,

Jody