Wide-range CRP versus high-sensitivity CRP on Roche analyzers: focus on low-grade inflammation ranges and high-sensitivity cardiac troponin T levels.

Abstract

Wide-range C-reactive protein (wr-CRP) has been proposed as an economical alternative to high-sensitivity C-reactive protein (hs-CRP) for the evaluation of low-grade inflammation-associated cardiovascular risk (LGI-CVR). Concomitant values of serum hs-CRP and plasma wr-CRP ≤5 mg/L, and high-sensitivity cardiac troponin T (hs-cTnT), all assayed on Roche Diagnostics analyzers over a 1.8-year period, were extracted from a hospital laboratory database. Hs-CRP and wr-CRP values were compared (Bland-Altman method; Deming's correlation), then separately classified into low (<1 mg/L), moderate (1-3 mg/L) and high (>3 mg/L) LGI-CVR ranges for agreement test (κ), assessed before and after Deming's regression-based adjustment of wr-CRP (Adj-wr-CRP). Wr-CRP and hs-CRP values were strongly correlated, with linearity, whether below 5 mg/L (n = 744; τ = 0.933; p < .001) or below 1 mg/L (n = 283; τ = 0.823; p < .001). Overall, wr-CRP values were lower than hs-CRP (mean bias: -0.11 ± 0.17 mg/L). Agreement was good, with 8.1% of wr-CRP values misclassified compared to hs-CRP (κ: 0.874), and weakly improved after regression-based adjustment (7.7% reclassified values; κ: 0.881). Lowering the Adj-wr-CRP cutoff of the moderate LGI-CVR subrange from 1.0 to 0.9 mg/L resulted in an almost perfect agreement (3.2% reclassified data; κ: 0.950). Hs-cTnT concentration was positively associated with hs-CRP, wr-CRP, and Adj-wr-CRP (p < .001). Within each LGI-CVR subrange, hs-cTnT medians were similar regardless of the hs-CRP, wr-CRP or Adj-wr-CRP used for risk classification. Based on hs-cTnT, this study supports the use of wr-CRP as a low-cost alternative to hs-CRP for cardiovascular risk evaluation.

• Authors: Denis Monneret, Fouzi Mestari, Shaedah Djiavoudine, Guillaume Bachelot, Maxime Cloison, Françoise Imbert-Bismut, Maguy Bernard, Pierre Hausfater, Jean-Marc Lacorte, Dominique Bonnefont-Rousselot
• Journal: Scandinavian journal of clinical and laboratory investigation (Scand J Clin Lab Invest) Vol. 78 Issue 5 Pg. 346-351 (Sep 2018) ISSN: 1502-7686 [Electronic] England
• PMID: 29764220 (Publication Type: Journal Article)

Chemical References

• Biomarkers
• Troponin T
• C-Reactive Protein

Topics

• Atherosclerosis (blood, diagnosis)
• Automation, Laboratory (standards)
• Biomarkers (blood)
• C-Reactive Protein (metabolism)
• Humans
• Inflammation
• Inventories, Hospital
• Regression Analysis
• Risk Factors
• Sensitivity and Specificity
• Severity of Illness Index
• Troponin T (blood)