Significance of High Sensitivity CRP

[Christie2004]

Hi,
Last Jan, my husband had a cardiology consult (at my insistence) for evaluation of cardiac risk factors. He is about 30# overwt, on Avapro, and his dad died at age 50 of a sudden massive MI without any previous warning signs. He doesn't smoke or drink.
His doc did a HS CRP at that time.  We were never told the result. In fact we were told if we don't hear anything, everything is ok.
We got the result yesterday, quite by accident with his routine lipid profile done 2 weeks ago.
Results: TC-214, trig-107,HDL-48, LDL-145, VLDL-21
His HS CRP from Jan 2004 was noted as abnormal, at 0.202 (0.0-0.07 normal for this lab) with the note that he is in the 4th quintile. Risk for CVE 1.7

His family doctor didn't make mention of it, either.  Just sent a diet sheet for a low fat diet, along with the lab report.  

Shouldn't he be on low dose aspirin? Any furthur testing indicated? I'm quite worried that no one seems to think he is at risk for an MI.  

I can't get him worked up about it, because the cardiologist and his family doctor don't seem interested or even concerned enough to mention it.

Your opinion?

[Cleveland Clinic]

christie,

thanks for your post.

CRP is a marker for inflammation in the artery and probably also plays a direct role in the development of coronary blockages.  The process of atherosclerosis involves the risk factors that we are all well aware of including diabetes, obesity, smoking and abnormal lipids.  However, many people that have one or all of these risk factors do not have an adverse event from atherosclerosis.  

What we have found is that by using markers such as CRP we can identify those with an increased risk of having a problem.  So CRP can identify those with active disease or 'inflammation' of the artery and help target or intensify medical therapy.

For your husband,  he's overweight and has abnormal lipids.  Those would be one of the main targets to try to first modify.  You can follow the CRP along with his progress.

As far as aspirin.  We need to weigh the risk of aspirin use against the benefits.  For your husband who is overweight, has high cholesterol, and a strong family history...I would probably consider it.  Discuss this with your physician.

Im sure his doctors are concerned.  A drastic lifestyle modification with weight loss and diet are going to be the most important therapies that can be offered.  Discuss starting this type of program with your physicians.


good luck

Luckily, many of the things that effect traditional risk factors can also modify crp.

[Christie2004]

He is 40 years old.  Doesn't exercise, very high stress job with extensive travel all over the world.