CRP vs Cardiac CRP

[ckent]

Is there any difference between a regular CRP and cardiac CRP? For some reason, they are labelled differently at the hospital that I am at and my intern doesn't know why.

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[Winged Scapula]

Presumably one is actually BLS (basic life saving/CPR) and one is ACLS (or advanced cardiac life support which includes training on meds, EKGs, defib, etc.).

 

[southerndoc]

Um, Kim, I think the question was about C-reactive proteins.

Unfortunately, I don't know the difference between regular CRP and cardiac CRP. I didn't know there was a difference... perhaps there is for reference values?

 

[Winged Scapula]

DOH!!!! Guess too many hours either in the OR or on-line affected my vision - thought it said CPR.

(yeah sure...everyone says)

 

[southerndoc]

Originally posted by Kimberli Cox
DOH!!!! Guess too many hours either in the OR or on-line affected my vision - thought it said CPR.

Too funny, too funny!

 

[tonem]

I thought it said CPR too

 

[Castro Viejo]

Well, I have nothing constructive to add.

But I did want to mention that while I saw "CRP" and knew the OP meant "CRP," I had no idea what it meant. Then Kim came in with her interpretation of "CPR" and I resolved that I knew even less than when I had woken up today.

Oh, and I think the reference values thing that the Geek mentioned is on the money. Nothing in the literature or anything I've heard points out any difference between a "cardiac CRP" or a regular CRP. Nothing in terms of assaying the stuff.

 

[southerndoc]

UGH... I just typed a post, got an error message, and ended up losing what I wrote.

Ritker, et al. in NEJM about CRP v. LDL in predicting first cardiac events: (you can do teh search for him with his name. I'm still pissed at losing my original post with this long list of article summaries!)

BACKGROUND: Both C-reactive protein and low-density lipoprotein (LDL) cholesterol levels are elevated in persons at risk for cardiovascular events. However, population-based data directly comparing these two biologic markers are not available. METHODS: C-reactive protein and LDL cholesterol were measured at base line in 27,939 apparently healthy American women, who were then followed for a mean of eight years for the occurrence of myocardial infarction, ischemic stroke, coronary revascularization, or death from cardiovascular causes. We assessed the value of these two measurements in predicting the risk of cardiovascular events in the study population. RESULTS: Although C-reactive protein and LDL cholesterol were minimally correlated (r=0.08), base-line levels of each had a strong linear relation with the incidence of cardiovascular events. After adjustment for age, smoking status, the presence or absence of diabetes mellitus, categorical levels of blood pressure, and use or nonuse of hormone-replacement therapy, the relative risks of first cardiovascular events according to increasing quintiles of C-reactive protein, as compared with the women in the lowest quintile, were 1.4, 1.6, 2.0, and 2.3 (P<0.001), whereas the corresponding relative risks in increasing quintiles of LDL cholesterol, as compared with the lowest, were 0.9, 1.1, 1.3, and 1.5 (P<0.001). Similar effects were observed in separate analyses of each component of the composite end point and among users and nonusers of hormone-replacement therapy. Overall, 77 percent of all events occurred among women with LDL cholesterol levels below 160 mg per deciliter (4.14 mmol per liter), and 46 percent occurred among those with LDL cholesterol levels below 130 mg per deciliter (3.36 mmol per liter). By contrast, because C-reactive protein and LDL cholesterol measurements tended to identify different high-risk groups, screening for both biologic markers provided better prognostic information than screening for either alone. Independent effects were also observed for C-reactive protein in analyses adjusted for all components of the Framingham risk score. CONCLUSIONS: These data suggest that the C-reactive protein level is a stronger predictor of cardiovascular events than the LDL cholesterol level and that it adds prognostic information to that conveyed by the Framingham risk score.

 

[Gator05]

Heh Heh...

This study (or one exceedingly similiar) came out earlier this year, right during cardiac path...

Question:
Why test only women? I'm thankful that this rather important ( ) 1/2 of the population is finally getting some recognition as far as heart disease goes...but why test only women?

While the publishing of this article is progress towards using CRP as a marker of risk for coronary events, I don't think formal guidelines have been published for general use of CRP in risk-stratification?

 

[southerndoc]

Originally posted by Gator05
why test only women?

There was an article in JAMA by the same guy (Riter at BWH/Harvard) that evaluated peripheral artery disease in male physicians.

So the research isn't all women.

 

[Gator05]

What I was asking was, why the researchers of THIS PARTICULAR study chose to include only women? I'm not faulting them; they must have had a good reason. I just don't know what it is yet!

 

[mcwmark]

Originally posted by Gator05
What I was asking was, why the researchers of THIS PARTICULAR study chose to include only women? I'm not faulting them; they must have had a good reason. I just don't know what it is yet!

He's taking data from the famous Women's Health Intiative, the same group of women they were following to find out that HRT wasn't such a good idea for your heart after all (earlier this summer). They have about 160,000 women in this study, and everyone is just data mining the heck out of them.

By the way, this guy's name is Paul Ridker (not Ritker) and he's a publishing machine.