Abstract 18279: Clinical Utility of hsCRP Testing at a University Based Hospital
Introduction: C-reactive protein (CRP), an acute-phase protein produced by hepatocytes, can be elevated in inflammatory and infectious states. Low level CRP elevation as detected by high sensitivity CRP (hsCRP) assays has been extensively studied in risk stratification in both cardiovascular primary prevention and active disease states. The current 2013 AHA guidelines on cardiovascular risk assessment do not recommend routine testing of hsCRP in primary prevention. It is suggested in specific patients as a supplement to traditional risk assessment. We aim to investigate the clinical utility of hsCRP testing at our center after its introduction as an in-house test.
Methods: All hsCRP tests ordered at our center between June 1st, 2014 and August 31st, 2015 were retrospectively identified. Data about the encounter information, provider details and the specific indications for each test was extracted by careful review of the electronic medical records.
Results: A total of 475 hsCRP tests were ordered at our center during the study period. We excluded 4 tests from analysis due to missing data. Of the remaining 471, 75 tests (15.92%) were ordered in emergency setting, 113 tests (23.99%) in inpatient setting and 283 tests (60.08%) in outpatient setting. Nurse practitioners ordered 68 tests (14.44%), attending physicians ordered 169 tests (35.67%) and residents/fellows ordered 234 tests (49.68%). Only 2 tests (0.43%) were ordered for primary prevention of CAD while the remaining 469 were ordered for detection and/or quantification of inflammation (392 tests, 83.22%) and infection (77 tests, 16.34%).
Conclusions: Although hsCRP was commonly tested at our center, its utilization for cardiovascular primary prevention was limited. Most of the testing was ordered for infection and inflammation suggesting that our providers could not differentiate hsCRP assay from the quantitative CRP assay. Although the results of our study are limited to a single center, we suspect that a substantial knowledge deficit exists in the applicability of hsCRP testing among the provider community. We believe that appropriate educational interventions and better designing of computerized order entry systems (CPOE) will overcome this deficit and optimize the utility of hsCRP testing.
- Inflammation and inflammatory markers
- Cardiovascular disease prevention
- Risk factors
Author Disclosures: R. Ponnapureddy: None. P. Patel: None. J. Ashraf: None. R. Mustafa: None.
- © 2016 by American Heart Association, Inc.