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BMC Cardiovascular Disorders

, 2:9

First Online: 23 May 2002Received: 20 July 2001Accepted: 23 May 2002DOI: 10.1186-1471-2261-2-9

Cite this article as: Riese, H., Vrijkotte, T.G., Meijer, P. et al. BMC Cardiovasc Disord 2002 2: 9. doi:10.1186-1471-2261-2-9

Abstract

BackgroundSerum C-reactive protein CRP has been identified in prospective epidemiological research as an independent risk marker for cardiovascular disease. In this paper, short-term biological variation of CRP is documented and a strategy to test the reliability of a single CRP sample is proposed.

MethodsData were obtained from three groups of healthy volunteers: men, no oral contraceptives OC-using women and OC-using women. Blood samples were obtained 3 times in men and twice in women during a workweek.

Results and discussionCRP values were highest in the OC-using women, followed by the men, and lowest in the no OC-using women. Averaged over the three groups the within-subject coefficients of variation CVi was 49.24% for CRP, and 29.90% for lnCRP. Using the repeated measures, individual samples were identified that reflected a -suspicious- unreliable high value, i.e. a value that was more than 2 standard deviations higher than the lowest value obtained from the same subject. In an a posteriori analysis, three strategies to identify these suspicious high CRP values were then tested. In terms of maximizing detection of suspicious values and minimizing unnecessary resampling, best results were obtained for the most pragmatic criterion of using an absolute level, stratified for gender, and OC-use, to decide whether a second sample should be obtained.

ConclusionA single high CRP value must be followed by re-sampling when it is above 1.75 mg-l for men, above 1.00 mg-l for no OC-using women, and above 2.00 mg-l for OC-using women.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2261-2-9 contains supplementary material, which is available to authorized users.





Author: Harriëtte Riese - Tanja GM Vrijkotte - Piet Meijer - Cees Kluft - Eco JC de Geus

Source: https://link.springer.com/







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