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]

References

 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.

Last reviewed: March 2023. The content for Optimal Testing: the Association for Diagnostics & Laboratory Medicine’s (ADLM) Guide to Lab Test Utilization has been developed and approved by the Academy of Diagnostics & Laboratory Medicine and ADLM’s Science and Practice Core Committee.

As the fields of laboratory medicine and diagnostic testing continue to grow at an incredible rate, the knowledge and expertise of clinical laboratory professionals is essential to ensure that patients receive the highest quality and most useful laboratory tests. ADLM’s Academy and Science and Practice Core Committee have developed a test utilization resource focusing on commonly misused tests in hospitals and clinics. Improper test utilization can result in poor patient outcomes and waste in the healthcare system. This important resource geared toward medical professionals recommends better tests and diagnostic practices. Always consult your laboratory director to make sure these recommendations are appropriate for your patient population.