Originally Published IVD Technology
March 2003
INDUSTRY NEWS
Experts recommend limiting CRP test useA panel of experts has recommended limiting the use of a blood test that has been widely promoted for assessing heart disease risk.
The American Heart Association (AHA; Dallas) and the Centers for Disease Control and Prevention (CDC; Atlanta) convened this panel, and its recommendations regarding the role of this blood test have been presented in an article in a recent issue of Circulation.
The test in question is the highly sensitive C-reactive protein (hs-CRP) test. CRP is an inflammatory marker found in the blood, and several previous studies have concluded that increased concentrations of CRP appear to be associated with greater risk for coronary heart disease, peripheral arterial disease, and sudden death. However, despite these findings, the panel has recommended against extensive use of this test.
“On the basis of the available evidence, the [panel] recommends against screening of the entire adult population for hs-CRP as a public health measure,” states the article. “The [panel] does conclude that it is reasonable to measure hs-CRP as an adjunct to the major risk factors to further assess absolute risk for coronary disease primary prevention.”
Thomas A. Pearson, MD, PhD, a cochairman of the panel, explains that while the hs-CRP test has been so widely publicized that many people have asked to be tested, health professionals have been given no formal guidelines about testing. For example, he says, tens of thousands of hs-CRP tests were ordered during the past two years, even though very little scientific evidence supported their widespread use.
George A. Mensah, MD, another cochairman of the panel and chief of the cardiovascular health program at CDC, adds that, “For clinicians and public health practitioners, it is important to emphasize that although abnormal hs-CRP values identify high-risk persons, we have no evidence that treatment strategies based on hs-CRP levels improve survival, or reduce cardiovascular complications.”
Industry analysts believe that while the panel has recommended limiting the use of the hs-CRP test, it still acknowledges the test’s diagnostic value.
“These are important guidelines for the medical community, given the effect that such guidelines can have on patient diagnosis and care in relation to heart disease,” says Mary Lou Gantzer, director of clinical and scientific affairs at Dade Behring (Deerfield, IL). “At the same time, these guidelines recognize that many well-designed studies have shown a strong relationship between the inflammatory process and cardiovascular disease, and that there are factors in addition to lipid testing to consider in assessing an individual’s risk for coronary heart disease. These guidelines are an important step, and they indicate that there is value in screening portions of the population for inflammation as another risk factor for cardiovascular disease.”
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