Perceptions of high-sensitivity C-reactive protein testing (hsCRP) in atherosclerotic cardiovascular disease: a US survey on cardiologists and nephrologists.

Abstract

Introduction: High-sensitivity C-reactive protein (hsCRP) is a biomarker of systemic inflammation (SI) and its elevated level is considered a risk-enhancing factor for cardiovascular disease in primary prevention. This study aimed to understand opinions of US clinicians using hsCRP testing in the management of patients with atherosclerotic cardiovascular disease (ASCVD) with or without chronic kidney disease (CKD).

Materials & methods: Clinicians who ordered hsCRP testing with evaluation of patient-level data were surveyed, between June 2023-August 2023. Endpoints included self-identified drivers and barriers to hsCRP testing and assessment of posttest actions following SI recognition.

Results: Common factors perceived to prevent hsCRP testing were a lack of evidence showing improvements in patient cardiovascular outcomes after addressing SI in ASCVD and CKD (50%), and lack of proven efficacy of hsCRP testing (33%). Barriers to hsCRP testing included cost, insurance coverage and patient refusal. The most common reason for not considering SI in clinical decision-making was that it would not affect management of ASCVD. After the first hsCRP testing, an average reduction of hsCRP level is observed, but not lower than 2 mg/L.

Conclusions: In this limited study sample, perceived limitations of hsCRP testing included insufficient evidence of improved cardiovascular outcomes in patients with ASCVD.