Just curious what your thoughts on wr-CRP for Cardiovascular disease screening? I’ve read that it can be a fairly inexpensive, concordant surrogate of hs-CRP which seems to be a reasonably good predictor of CVD. I’m a physician myself and some of these “executive screening panels” (which are largely over-investigative both IMO and based on existing guidelines) occasionally come to me for review.
I would imagine, the issue would be whether there would be a clear actionable thing to do on a raised wr-CRP outside of lipid/glucose control, the typical health promoting diet, meet physical activity guidelines, proper sleep, tobacco cessation, etc.
I’m more familiar with hs-CRP, which is relatively inexpensive and has some data showing it can be useful to further characterize ASCVD risk in addition to atherogenic lipid measurements. The JUPITER, CANTOS, and ARIC studies immediately come to mind here, with the latter being the most provocative IMO. They found that the hs-CRP was able to predict ASCVD in individuals with normal atherogenic parameters, e.g. the CRP and lipid panels (and subsequent risk scores) were discordant.
The other question is how it affects management, which is more complicated. Could you prescribe a statin in a person with a high CRP and normal lipid panel or get more buy-in from an individual with this additional data? I think there’s room for discussion there. I don’t see a lot of potential harms outside of cost here, but that’s just my 0.02.
Got a few references here showing the concordance between hs-CRP and wr-CRP: (i believe wr-CRP is cheaper in my country hence why some people are using it in their screening panels… probably profit related)
That said, are you aware of any guidelines regarding use of CRP (hs or wr) in screening at the present moment?