High Sensitivity C-Reactive Protein (hs- CRP)

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hs-CRP detects subtle inflammation and is used primarily to assess cardiovascular risk.

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High Sensitivity C-Reactive Protein (hs-CRP) Test Information Guide

Why is it done?
- Test Measures: hs-CRP detects low levels of C-reactive protein, an inflammatory marker produced by the liver in response to inflammation or infection. It is more sensitive than conventional CRP tests, capable of detecting inflammation at levels as low as 0.1 mg/L.
- Primary Indications: Cardiovascular risk assessment in patients without prior cardiac events; evaluation of chronic inflammation; monitoring response to anti-inflammatory therapy; assessment of infection and sepsis; evaluation of acute inflammatory conditions
- Typical Timing: Performed during routine cardiovascular screening; when evaluating unexplained inflammatory symptoms; in preventive health assessments for middle-aged and older adults; at baseline and follow-up for chronic disease management
Normal Range
- Reference Values: Less than 1.0 mg/L: Low cardiovascular risk 1.0 - 3.0 mg/L: Average cardiovascular risk Greater than 3.0 mg/L: High cardiovascular risk
- Units of Measurement: Milligrams per liter (mg/L)
- Interpretation Guide: Normal (< 1.0 mg/L): Indicates low inflammatory activity and lower cardiovascular risk; suggests healthy inflammatory response Borderline Elevated (1.0-3.0 mg/L): Indicates moderate inflammatory activity; may suggest intermediate cardiovascular risk; warrants lifestyle modifications and monitoring Elevated (> 3.0 mg/L): Indicates significant inflammation; associated with higher cardiovascular risk, increased risk of myocardial infarction and stroke; may indicate acute infection or chronic inflammatory disease
- Clinical Significance: Normal results suggest absence of systemic inflammation; abnormal results indicate active inflammatory process requiring further investigation and management
Interpretation
- Result Value Interpretation: < 1.0 mg/L: Low risk profile; minimal inflammatory burden; favorable cardiovascular prognosis 1.0-1.9 mg/L: Mild elevation; monitor and consider preventive measures 2.0-3.0 mg/L: Moderate elevation; increased risk of cardiovascular events; lifestyle intervention recommended > 3.0 mg/L: Significant elevation; substantial inflammatory burden; increased risk of acute cardiovascular events; requires medical intervention
- Clinical Condition Indicators: Acute elevation (> 10 mg/L): Suggests acute infection, myocardial infarction, or acute inflammatory disease Chronic mild elevation (1.0-3.0 mg/L): Associated with chronic inflammation, metabolic syndrome, obesity, or chronic infection Persistent elevation despite treatment: May indicate inadequate disease control or need for treatment adjustment
- Factors Affecting Results: Recent infection or vaccination: Can elevate CRP for several weeks Acute inflammation: Increases rapidly within hours Obesity: Associated with chronic mild elevation Smoking: Increases baseline levels Hormone therapy: May influence CRP levels Recent surgery or trauma: Causes acute elevation Rheumatoid arthritis and autoimmune diseases: Chronically elevated Age and gender: Slight variations in reference ranges
- Cardiovascular Risk Stratification: hs-CRP is used in combination with lipid profiles and other risk factors to calculate global cardiovascular risk; elevated hs-CRP in patients with normal lipid levels may indicate increased risk requiring closer monitoring
Associated Organs
- Primary Organ Systems: Liver: Primary source of CRP production Cardiovascular system: Primary clinical focus; elevated CRP indicates increased risk of atherosclerosis, myocardial infarction, and stroke
- Commonly Associated Conditions: Cardiovascular: Atherosclerotic heart disease, myocardial infarction, unstable angina, heart failure, peripheral arterial disease, stroke Infectious: Pneumonia, bacterial infections, viral infections, urinary tract infections, sepsis Inflammatory: Rheumatoid arthritis, systemic lupus erythematosus, inflammatory bowel disease, Crohn's disease, ulcerative colitis Metabolic: Type 2 diabetes mellitus, metabolic syndrome, obesity Other: Malignancy, kidney disease, acute appendicitis
- Diagnostic Applications: Risk stratification for cardiovascular disease; monitoring of inflammatory disease activity; assessment of infection severity; prognostic indicator for adverse outcomes; monitoring effectiveness of anti-inflammatory therapy
- Associated Complications: Persistent elevation associated with increased risk of: myocardial infarction, sudden cardiac death, ischemic stroke, atherosclerotic plaque rupture, systemic inflammation progression, chronic disease complications
Follow-up Tests
- Recommended Follow-up Tests: Lipid panel: Total cholesterol, LDL, HDL, triglycerides for cardiovascular risk assessment Lipoprotein (a): Additional cardiovascular risk factor Homocysteine: Inflammatory marker associated with cardiovascular disease Fibrinogen: Marker of inflammation and coagulation risk
- Diagnostic Workup for Elevated Results: Complete blood count (CBC): Assess for infection and immune response Comprehensive metabolic panel: Evaluate organ function and systemic health Thyroid function tests (TSH, free T4): Rule out thyroid disease Autoimmune markers: ESR, ANA panel if autoimmune disease suspected Tissue culture: If infectious disease indicated Cardiac stress testing or imaging: If cardiovascular disease suspected
- Cardiovascular Imaging: Electrocardiogram (ECG): Baseline cardiac assessment Echocardiography: Evaluate cardiac structure and function CT coronary angiography: Assess for coronary artery disease Carotid ultrasound: Evaluate for atherosclerotic burden
- Monitoring Schedule: Initial assessment: At baseline evaluation Chronic disease monitoring: Every 3-6 months during treatment Cardiovascular risk assessment: Annually for high-risk patients Post-acute event: 2-4 weeks after acute illness or intervention Response to therapy: 4-8 weeks after starting anti-inflammatory treatment
- Complementary Tests: Framingham Risk Score: Combined with other markers for cardiovascular risk Reynolds Risk Score: Uses hs-CRP as component of risk calculation Inflammatory biomarkers: Interleukin-6, TNF-alpha for research purposes Vascular imaging markers: Carotid intima-media thickness, arterial stiffness
Fasting Required?
- Fasting Requirement: No - Fasting is NOT required for hs-CRP testing. The test can be performed on a non-fasting sample without affecting accuracy or interpretation.
- Specimen Collection: Peripheral venous blood sample obtained by routine venipuncture; typically 3-5 mL of blood collected in a serum separator tube (SST) or EDTA tube
- Patient Preparation: No specific fasting required Can eat and drink normally before the test No special dietary restrictions Arrive for appointment in normal clothing; no need for special attire Arrive well-hydrated Avoid strenuous exercise for 24 hours prior to test (optional but recommended for more accurate results)
- Medications: Continue all regular medications as prescribed No need to discontinue medications prior to testing Inform laboratory staff of all current medications, especially anti-inflammatory agents (NSAIDs, corticosteroids, statins) Hormone replacement therapy should be noted as it can affect CRP levels Aspirin and other cardiovascular medications do not require discontinuation
- Timing Considerations: Schedule test when patient is at baseline health (not during acute illness) Wait at least 2 weeks after acute infection, recent surgery, or trauma for baseline assessment Wait 4-6 weeks after vaccinations if possible Morning appointments preferred for consistency Avoid testing during significant stress or emotional upheaval
- Special Instructions: Bring insurance card and photo identification Complete any required forms prior to visit Notify healthcare provider if taking over-the-counter anti-inflammatory medications For serial monitoring, try to schedule appointments at similar times of day Report any recent illnesses, injuries, or lifestyle changes to physician Results may take 24-48 hours for processing

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