High-sensitivity C-reactive Protein (hs-CRP): Optimal Testing Recommendations

This test is recommended for atherosclerotic cardiovascular diseases (CVD) risk assessment only.

Guidelines for Test Utilization

What does the test tell me?

hs-CRP, as a biomarker of inflammation, is an important indicator of underlying atherosclerosis which is a risk factor for cardiovascular events. [back to top]

When should I order this test?

To evaluate the risk of atherosclerotic CVD. [back to top]

When should I NOT order this test?

Do not use hs-CRP to investigate causes of inflammation.

Do not use hs-CRP as a screening test to rule out the presence of atherosclerotic CVD, or as the only laboratory test for assessment of atherosclerotic CVD. [back to top]

How should I interpret the result?

hs-CRP <2.0 mg/L: Lower risk of CVD. However, this does not exclude the risk of CVD.

hs-CRP >/= 2.0 mg/L: Higher risk of CVD. [back to top]

Is the test result diagnostic/confirmatory of the condition?

No. hsCRP measurement complements but does not replace other laboratory and imaging tests for atherosclerotic CVD evaluation. Currently, there is no single diagnostic/confirmatory test for the risk assessment of atherosclerotic cardiovascular diseases. [back to top]

Are there factors that can affect the lab result?

The monoclonal IgM gammopathy and Rheumatoid Factors may cause unreliable results of hs-CRP. [back to top]

Are there considerations for special populations?

The current cut-off values for hs-CRP are only used for adults and should not be used in pediatrics. [back to top]

What other test(s) might be indicated?

  • LDL-c
  • Triglycerides
  • Lp(a)
  • apoB

[back to top]


 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019 Sep 10;140(11):e596-e646.