ISO 9001:2008(International Standards Certifications),L.

N : 15ISO1370
XYlZ Ldqy ds lkeus] iapk;r lfefr nqdku ua-14] tokbZ ck¡/k jksM] lqesjiqj¼ikyh½ -306902,Ph:02933-252959
czkap vkW-% vk;Z lekt ds ihNs]fgjkxj okMh]f'koxat]¼fljksgh½-307027,Ph:02976-270559
Email:info@shrikrishnalab.com,shrikrishnapathlab@gmail.com,www.shrikrishnalab.com

Mr.K.N.Prajapati Mrs.H.K.Prajapati Dr. S.M. Shah

B.Sc.,B.P.T.,M.L.T.,P.G.M.L.T.(I.K.D.R.C.) P.G.M.L.T.,(L.B.S.),C.F.N M.B.B.S.,D.C.P
Mo:09462272559 Mo:09829552959 Consultant Pathologist

High Sensitivity C-Reactive Protein (hs-CRP)

Coronary heart disease (CHD) remains the leading cause of morbidity and mortality in the developed world.
Atherosclerosis, the underlying cause of most CHD, is a process that starts early in the life and progress slowly
and silently for decades.Clinical and laboratory studies have shown that inflammation plays a major role in the
initiation, progression and stabilization of atheromas. The clinical manifestation usually occurs in the form of
myocardial infarction(MI), stroke,angina or sudden death.
Cholesterol / Lipid profile screening has been used as a tool to identify individuals who are at increased risk of
developing future coronary events. Although this approch has been useful, it fails to identify almost one half of the
individuals who develop MI having normal or moderate elevation in the serum cholesterol level. In order to identify
such persons,risk markers used are :

Lipoproteins a : Desirable level for the adult less than 30 mg/dl

Apo A1 : Desirable level for the adult less than 123 mg/dl
Apo B : Desirable level for the adult less than 100 mg/dl
Homocysteine : Desirable level for the adult less than 16 umol/ml
Fibrinogen : Desirable level for the adult less than 300 mg/dl
Hs-CRP : Desirable level for the M : 0.0 - 1.5 mcg/ml F : 0.0 - 2.5 mcg/ml

C-reactive protein – An introduction

C - reactive protein is an alpha globulin of molecular weight 110-140 KD. It is synthesized in liver and
is normally present as a trace constituent of serum or plasma at levels less than 0.3 mg/dl. It
was named as such for its ability to bind and precipitate the C- polysaccharide of pneumococcus. C –
Reactive protein has traditionally been used to diagnose and monitor acute inflammation. Since,
atherosclerosis is an inflammatory process, production of CRP starts much ahead of cholesterol
deposition in the heart, thus, making CRP an extremely valuable indicator of CVD.s

Difference in levels of CRP in inflammation and heart disease

What sets inflammation and heart disease apart is the level of elevation of CRP. In inflammatory
conditions like arthritis, ulcerative colitis, infections, etc,CRP levels may rise to levels as high as 1000
times the upper limit of normal. Whereas, in cardiac disease, the increase in CRP is only two- or three-
folds greater than normal.

Differentiation between conventional and cardiac CRP

As is evident, to detect the subtle changes in the CRP levels, in CVD a much more sensitive method
is required. Methodological and instrumental improvements have made it possible to design a CRP
test, which can detect very low levels of CRP. Thus has emerged the hs-CRP (high sensitivity C-
reactive protein) test. This particular test is distinctly different from the conventional CRP test. The
hs-CRP test is reported in mg/L (μg/ml). There is a 10-fold difference among the reporting units of
conventional and high sensitive CRP tests. The Hs-CRP test needs to be highly sensitive.
A sensitivity of around 0.2μg/ml would be very effective.

Here’s a comparison between the Conventional and the hs-CRP tests

Parameters Conventional CRP Test HS CRP/ Cardiac CRP

Reporting Units Mg/dl Mg/L (µg/ml)
Sensitivity 0.01mg/dl 0.2µg/ml
Linearity 30 mg/dl 30 µg/ml
Based upon Turbidimetry /Agglutination Streptavidin- Biotin Sandwich Immunoassay
Purpose General Inflammation Risk for cardiovascular disease

1
 ISO 9001:2008(International Standards Certifications),L.N : 15ISO1370
XYlZ Ldqy ds lkeus] iapk;r lfefr nqdku ua-14] tokbZ ck¡/k jksM] lqesjiqj¼ikyh½ -306902,Ph:02933-252959
czkap vkW-% vk;Z lekt ds ihNs]fgjkxj okMh]f'koxat]¼fljksgh½-307027,Ph:02976-270559
Email:info@shrikrishnalab.com,shrikrishnapathlab@gmail.com,www.shrikrishnalab.com

Mr.K.N.Prajapati Mrs.H.K.Prajapati Dr. S.M. Shah

B.Sc.,B.P.T.,M.L.T.,P.G.M.L.T.(I.K.D.R.C.) P.G.M.L.T.,(L.B.S.),C.F.N M.B.B.S.,D.C.P
Mo:09462272559 Mo:09829552959 Consultant Pathologist

Interpretation of Results
The high-sensitivity C-reactive protein (hs-CRP) test helps determine heart disease risk often
along with tests for cholesterol and triglycerides. The results are generally interpreted on a relative
scale. People with the highest values have the highest risk of cardiovascular disease and those with
the lowest values have the lowest risk.

Expected values for hs – CRP assay are as follows-:

Low Risk = < 1.0 μg/ml
Normal = 1-3 μg/ml
High Risk = > 3.0 μg/ml

Others Applications:
# Neonatal Septicemia (>2-3μg/ml)
# Assesment and monitoring of Rheumatic disease & SLE
(hs - CRP is better than ESR, Rheumatoid factor or immunoglobulins)
# In differential diagnosis of Bacterial v/s Viral infections
(Bacterial infections have raised hs-CRP , Viral infection do not raised )
# To monitor unstable agnina pectoris & Peripheral arterial Disease
# In monitoring antibiotic therapy especially to detect inflammatory complications
(hs-CRP is raised if s/s of inflammations are present)
# in case of severe infections e.g.
Septicemia
Endocarditis hs-CRP > 100 μg/ml suggest severe bacterial infection
Osteomylitis
Meningitis hs-CRP < 20 μg/ml suggest viral meningitis
Pneumonia hs-CRP > 60 μg/ml suggest bacterial pneumonia
Bronchitis hs-CRP is usually negative
Sinusitis hs-CRP > 20 μg/ml Maxillary sinusitis
Pharyngitis hs-CRP >35μg/ml suggest bacterial Pharyngitis
UTI hs-CRP > 100 - 140 μg/ml suggest pyelonephritis
PID hs-CRP detective value
MI hs-CRP > 40 - 160 μg/ml
Burns,Surgery hs-CRP >raised suggest infection
Appendiciti hs-CRP > 100 μg/ml Dianostic value

OTHER CARDIAC MARKER AVAILABLE

TROPONIN - I(QUANT.CLIA) HOMOCYSTINE
TROPONIN - T(QUANT.CLIA) LIPID PROFILE
MYOGLOBIN NT-PRO BNP
Hs-CRP Apo A1
LDH Apo B
CPK Lp(a)
CPK MB

This is a property of Krishna Lab. Circulation strictly for technical purposes only.