From the Guidelines
Your hsCRP level of 22.30 mg/L indicates significant inflammation in your body and requires prompt medical attention. This level is well above the normal range (less than 3 mg/L) and suggests an active inflammatory process 1. You should contact your healthcare provider immediately for evaluation, as this level could indicate various conditions including infection, autoimmune disease, cardiovascular disease, or tissue injury.
Key Considerations
- The high value suggests this is likely an acute inflammatory response rather than the low-grade inflammation associated with cardiovascular risk assessment, which is why prompt medical evaluation is essential to identify and treat the underlying cause 1.
- Your doctor will likely order additional tests to determine the cause, which could include a complete blood count, erythrocyte sedimentation rate, and possibly imaging studies.
- While waiting for your appointment, you can take anti-inflammatory medications like ibuprofen (400-600mg every 6-8 hours with food) if approved by your doctor, but this is not a substitute for proper medical evaluation 1.
- Avoid strenuous exercise and get adequate rest until you're evaluated.
Importance of Prompt Evaluation
The significance of an elevated hsCRP level, especially one as high as 22.30 mg/L, cannot be overstated. It is crucial to identify the underlying cause of this inflammation to provide appropriate treatment and prevent potential complications. The recommendations from the Centers for Disease Control and Prevention and the American Heart Association emphasize the importance of measuring hsCRP as an adjunct to major risk factors to further assess absolute risk for coronary disease primary prevention 1. However, in the case of a significantly elevated hsCRP level like yours, the focus should be on identifying and treating the cause of the inflammation rather than solely on cardiovascular risk assessment.
From the Research
Significance of Elevated High-Sensitivity C-Reactive Protein (hsCRP) Level
- An elevated hsCRP level of 22.30 mg/L is significantly higher than the levels mentioned in the studies as being associated with increased cardiovascular risk 2, 3.
- According to the study by 3, hsCRP levels of less than 1 to 3, and greater than 3 mg/L are associated with lower, moderate, and higher cardiovascular risks, respectively.
- The study by 4 found that elevated hsCRP levels (>0.32 mg/dL) are associated with a worse clinical profile and earlier adverse events in patients with advanced peripheral arterial disease.
- Another study by 5 found that hsCRP levels are significantly lower in SLE patients with disease flare than in those with active infection, and that elevated hsCRP levels can be used as a predictor of active infection in SLE patients with a high specificity.
- The study by 6 found that hsCRP levels above the median level of 5.3 mg/l were associated with a highly increased mortality in patients with cirrhosis.
Association with Cardiovascular Risk
- Elevated hsCRP levels are associated with an increased risk of cardiovascular events, including coronary artery disease, myocardial infarction, and peripheral artery disease 2, 3, 4.
- The predictive value of hsCRP is independent of classic risk factors, such as elevated serum cholesterol 2.
- hsCRP levels are also associated with a higher risk of developing peripheral artery disease and with a faster progression of carotid artery disease 2.
Clinical Implications
- The measurement of hsCRP levels may be useful in identifying individuals at high risk of cardiovascular events, particularly those with elevated levels (>3 mg/L) 3.
- However, routine measurement of hsCRP for cardiovascular risk assessment is currently not recommended due to its low accuracy and lack of a clear cut-off point for elevated hsCRP levels 2.
- Elevated hsCRP levels may also be useful in predicting survival and haemodynamics in patients with cirrhosis 6, and in predicting active infection in SLE patients 5.