High Sensitivity (Cardiac Risk Assessment)

CPT Test code: 86141

Related Documents:	High-sensitivity Testing for C-Reactive Protein (hs-CRP) • Spanning the Continuum of Cardiovascular Care
Related Information:	C-Reactive Protein (CRP), Quantitative
Specimen:	Serum or plasma
Volume:	1 mL
Minimum Volume:	0.5 mL (Note: This volume does not allow for repeat testing.)
Container:	Red-top tube, gel-barrier tube, lavender-top (EDTA) tube, or green-top (heparin) tube
Special Instructions:	State patient’s sex on the request form.
Collection:	Separate serum or plasma from cells within one hour of collection. To avoid delays in turnaround time when requesting multiple tests on frozen samples, please submit separate frozen specimens for each test requested.
Storage Instructions:	Refrigerate
Causes for Rejection:	Gross lipemia
Reference Interval:	Average hs-CRP level:¹• Low risk: <1.00 mg/L • Average risk: 1.00-3.00 mg/L • High risk: >3.00 mg/L
Use:	Measurement of CRP by high sensitivity CRP assays may add to the predictive value of other markers used to assess the risk of cardiovascular and peripheral vascular disease.^2-8
Limitations:	Increases in CRP values are nonspecific. CRP is an indicator for a wide range of disease processes and should not be interpreted without a complete clinical history. Recent medical events resulting in tissue injury, infections, or inflammation, which may cause elevated CRP levels, should also be considered when interpreting results. Serial analysis of CRP should not be used to monitor the effects of treatment.
Footnotes:	1. Pearson TA, Mensah GA, Alexander RW, et al. 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; 107(3):499-511.PubMed 125518782. Ridker PM, Cushman M, Stampfer MJ, et al. Plasma concentration of C-reactive protein and risk of developing peripheral vascular disease. Circulation. 1998; 97(5):425-428. PubMed 9490235 3. Ridker PM, Cushman M, Stampfer MJ, et al. Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men. N Engl J Med. 1997; 336(14):973-979.PubMed 9077376 4. Ridker PM, Buring JE, Shih J, et al. Prospective study of C-reactive protein and the risk of future cardiovascular events among apparently healthy women. Circulation. 1998; 98(8):731-733. PubMed 9727541 5. Ridker PM, Glynn RJ, 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(20):2007-2011. PubMed 9610529 6. Ridker PM, Rifai N, Peffer MA, et al, for the Cholesterol and Recurrent Events (CARE) Investigators. Inflammation, pravastatin, and the risk of coronary events after myocardial infarction in patients with average cholesterol levels. Circulation. 1998; 98(9):839-844. PubMed 9738637 7. Tracy RP, Lemaitre RN, Psaty BM, et al. Relationship of C-reactive protein to risk of cardiovascular disease in the elderly: Results from the Cardiovascular Health Study and the Rural Health Promotion Project. Arterioscler Thromb Vasc Biol. 1997; 17(6):1121-1127. PubMed 9194763 8. Macy EM, Hayes TE, Tracy RP. Variability in the measurement of C-reactive protein in healthy subjects: Implications for reference interval and epidemiological applications. Clin Chem. 1997; 43(1):52-58. PubMed 8990222