CDCAHA Scientific Statement on Inflammatory Markers and Cardiovascular Disease: Recommendations for

1
CDC/AHA Scientific Statement on Inflammatory
Markers and Cardiovascular Disease
Recommendations for Population Science

• Class III (evidence/agreement that the procedure
  is not useful/effective and may be harmful),
  Evidence level C (consensus opinion of experts)
• The entire adult population should not be
  screened for hs-CRP for purposes of
  cardiovascular risk assessment

Pearson TA et al. Circulation 2003107499511.
2
CDC/AHA Scientific Statement on Inflammatory
Markers and Cardiovascular Disease
Recommendations for Laboratory Testing

• Class IIa (in favor of usefulness), Evidence
  level B (data derived from nonrandomized studies)
• 2 measurements, optimally 2 weeks apart, should
  be averaged, in fasting or nonfasting
  metabolically stable patients. If hs-CRP gt10
  mg/L, test should be repeated and patient
  examined for sources of infection or inflammation
• hs-CRP risk categories
• Low lt1 mg/L
• Average 13 mg/L
• High gt3 mg/L

Pearson TA et al. Circulation 2003107499511.
3
CDC/AHA Scientific Statement on Inflammatory
Markers and Cardiovascular Disease
Recommendations for Clinical Practice (I)

• Class IIa (in favor of usefulness), Evidence
  level B (data derived from nonrandomized studies)
• In patients at intermediate global risk
  (1020/10 yr), hs-CRP measurement may help
  direct evaluation and therapy for primary
  prevention benefits uncertain.
• Patients with persistent unexplained hs-CRP
  elevation gt10 mg/L should be evaluated for
  noncardiovascular etiologies.
• In patients with stable coronary disease or ACS,
  hs-CRP may be useful as a marker of prognosis for
  recurrent events benefits uncertain.

Pearson TA et al. Circulation 2003107499511.
4
CDC/AHA Scientific Statement on Inflammatory
Markers and Cardiovascular Disease
Recommendations for Clinical Practice (II)

• Class IIb (usefulness less well established),
  Evidence level B (data derived from nonrandomized
  studies)
• hs-CRP measurement may be used as part of global
  risk assessment in primary prevention benefits
  uncertain.
• hs-CRP may improve motivation for lifestyle
  modification benefits uncertain.

Pearson TA et al. Circulation 2003107499511.