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C Reactive Protein, High Sensitivity

hs-CRP, hs CRP, hsCRP, CRP, C-Reactive Protein, High-Sensitivity

Test Codes

EPIC: LAB6454, Beaker: CRPHS, Antrim: 31361

Department

Chemistry

Specimen Collection Criteria

Collect: One Gold-top SST tube.

Physician Office/Draw Specimen Preparation

Let specimen clot 30-60 minutes then immediately centrifuge to separate serum from cells within two hours of collection. Refrigerate (2-8°C or 36-46°F) the centrifuged collection tube within twelve hours of collection.

Preparation for Courier Transport

Transport: Centrifuged collection tube, refrigerated (2-8 °C or 36-46 °F). (Minimum: 0.5 mL)

Rejection Criteria

• Plasma specimens.
• Hemolyzed specimens.
• Severely lipemic specimens.

In-Lab Processing

Let specimen clot 30-60 minutes then immediately centrifuge to separate serum from cells within two hours of collection. Deliver immediately to the appropriate testing station.

Storage

Specimen Stability for Testing:

Centrifuged SST Tubes and Microtainers^® with Separator Gel
Room Temperature (20-26°C or 68-78.8°F): 24 hours
Refrigerated (2-8°C or 36-46°F): 7 days
Frozen (-20°C/-4°F or below): Unacceptable

Serum Specimens (Pour-Overs)
Room Temperature (20-26°C or 68-78.8°F): 12 hours
Refrigerated (2-8°C or 36-46°F): 3 days (Grosse Pointe)
Refrigerated (2-8°C or 36-46°F): 7 days (Royal Oak)
Frozen (-20°C/-4°F or below): 3 months

Specimen Storage in Department Prior to Disposal:

Refrigerated (2-8°C or 36-46°F): 7 days

Laboratory

Dearborn Chemistry Laboratory
Farmington Hills Chemistry Laboratory
Royal Oak Automated Chemistry Laboratory

Performed

Sunday – Saturday, 24 hours a day.
Results available within 24 hours.

Reference Range

<1.0 mg/L.

Test Methodology

Immunoturbidimetric.

Interpretation

CRP is a non-specific marker of inflammation. A variety of conditions including acute bacterial and viral illnesses, acute rheumatoid arthritis, acute myocardial infarction and widespread malignant disease are usually associated with increased levels. CRP levels respond to inflammation within 8 hours of onset and peak levels are reached within 24-48 hours. Levels may rise to 2000 times normal.

Recent studies have also indicated that a baseline CRP level may be useful in assessing an individual's risk of developing a coronary event, stroke, or peripheral vascular disease. Such risk assessment testing is best performed at a time when the patient does not have any known active inflammation. In order to determine CRP concentrations at lower baseline levels, the high-sensitivity CRP (hs-CRP) test may be ordered. The test has been recommended for further risk stratification of patients considered at moderate risk by standard global risk assessment. The decision intervals given below correspond to approximate tertiles of hs-CRP in the adult population (see References below). 

0 - 0.9 mg/L	Low risk of cardiovascular disease and stroke.
1.0 - 3.0 mg/L	Moderate risk of cardiovascular disease and stroke.
3.1 - 10.0 mg/L	High risk of cardiovascular disease and stroke. Recommend waiting at least two weeks to repeat testing when the patient is metabolically stable, free of infection or acute illness. The lower of the two results should be considered the patient's value.
Greater than 10 mg/L	Possible acute phase response, however cannot exclude potential for very high risk of cardiovascular disease and stroke. Recommend waiting at least 3 weeks to repeat testing, when the patient is metabolically stable, free of infection or acute illness.

Simultaneous measurements of hs-CRP and lipids predict future vascular risk better than lipid measurements alone. In women, hs-CRP concentrations may be influenced by hormonal status.

Clinical Utility

In an apparently healthy adult or in the absence of a known inflammatory process, hs-CRP assesses an individual's risk of developing a coronary event, stroke or peripheral vascular disease.

Reference

1. Rider PM, Glynn ZRJ, and Hennekens CH. C-Reactive protein adds to the predictive value of total and HDL cholesterol in determining risk of first myocardial infarction. Circulation 1998; 97:2007-2011.
2. Pearson TA, Mensah GA, Alexander RW, Anderson JL, Cannon RO 3^rd, Criqui M, Fadl YY, Fortman SP, Hong Y, Myers GL, Rifai N, Smith SC Jr., Taubert K, Tracy RP, Vinicor F; Centers for Disease Control and Prevention: American Heart Association. Markers of Inflammation and Cardiovascular Disease: Application to Clinical and Public Health Practice: A Statement for Healthcare Professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation. 2003 Jan 28; 107(3):499-511. PMID:12551878.
3. NACB LMPG Committee Members, Myers GL, Christenson RH, Cushman M, Ballantyne CM, Cooper GR, Pfeiffer CM, Grundy SM, Labarth DR, Levy D, Rifai N, Wilson PW. 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. Epub 2008 Dec 23. PMID:19106185.

CPT Codes

86141

Contacts

Last Updated

10/3/2023