We would like to respond to the recent Commentary by Levinson and Elin1 on the role of high-sensitivity C-reactive protein (hs-CRP) measurement and its usefulness as a screening tool for coronary heart disease (CHD). In a well-designed reanalysis of data from a case-control analysis by Ridker et al2 of incident CHD in the Women's Health Study, Levinson and Elin point out that the highest quartile of hs-CRP had a positive predictive value (PPV) of only 0.86%. We agree with their assertion that a PPV of 0.86% is inadequate for use in widespread screening, and thus it is possible that hs-CRP may not become widely used for population-based screening for CHD in a similar, healthy population with equally low prevalence of disease.
Wiesbauer F, Miles JS. C-Reactive Protein Screening for Cardiovascular Disease. Arch Intern Med. 2003;163(2):242. doi:10.1001/archinte.163.2.242-a