Editing C-reactive protein (section)

=== Coronary heart disease risk ===

Arterial damage results from [[macrophage|white blood cell]] invasion and [[inflammation]] within the wall. CRP is a general marker for inflammation and infection, so it can be used as a very rough proxy for heart disease risk. Since many things can cause elevated CRP, this is not a very [[Sensitivity and specificity|specific]] prognostic indicator.<ref name="Lloyd-Jones">{{cite journal | vauthors = Lloyd-Jones DM, Liu K, Tian L, Greenland P | title = Narrative review: Assessment of C-reactive protein in risk prediction for cardiovascular disease | journal = Annals of Internal Medicine | volume = 145 | issue = 1 | pages = 35–42 | date = July 2006 | pmid = 16818927 | doi = 10.7326/0003-4819-145-1-200607040-00129 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Bower JK, Lazo M, Juraschek SP, Selvin E | title = Within-person variability in high-sensitivity C-reactive protein | journal = Archives of Internal Medicine | volume = 172 | issue = 19 | pages = 1519–1521 | date = October 2012 | pmid = 22945505 | pmc = 3613132 | doi = 10.1001/archinternmed.2012.3712 }}</ref> Nevertheless, a level above 2.4&nbsp;mg/L has been associated with a doubled risk of a coronary event compared to levels below 1&nbsp;mg/L;<ref name=Pepys/> however, the study group in this case consisted of patients who had been diagnosed with unstable angina pectoris; whether elevated CRP has any predictive value of acute coronary events in the general population of all age ranges remains unclear. Currently, C-reactive protein is not recommended as a cardiovascular disease screening test for average-risk adults without symptoms.<ref name=Cecil>{{cite book | vauthors = Goldman L |title=Goldman's Cecil Medicine |url=https://archive.org/details/goldmanscecilmed00mdle |url-access=limited |publisher=Elsevier Saunders |location=Philadelphia |isbn=978-1437727883 |year=2011 |pages=[https://archive.org/details/goldmanscecilmed00mdle/page/n317 54] |edition=24th }}</ref>

The [[American Heart Association]] and U.S. [[Centers for Disease Control and Prevention]] have defined risk groups as follows:<ref>{{cite web |url=http://labtestsonline.org/understanding/analytes/hscrp/tab/test |title=hs-CRP |access-date=June 3, 2013}}</ref><ref name="pmid12551878" />
* Low Risk: less than 1.0&nbsp;mg/L
* Average risk: 1.0 to 3.0&nbsp;mg/L
* High risk: above 3.0&nbsp;mg/L
But hs-CRP is not to be used alone and should be combined with elevated levels of [[cholesterol]], [[LDL-C]], [[triglycerides]], and glucose level. [[Smoking]], hypertension and diabetes also increase the risk level of cardiovascular disease.