Podcast Summary: Healthier World with Quest Diagnostics

Episode: Instant insights: hs-CRP in cardiovascular risk
Date: January 26, 2026
Host/Guest: Dr. Mason Latsko for Quest Diagnostics
Duration: 7 minutes

Episode Overview

This short yet information-packed episode, hosted by Dr. Mason Latsko, focuses on understanding the role of high-sensitivity C-reactive protein (hs-CRP) as a biomarker for cardiovascular risk. The discussion highlights why cardiovascular events often stem from inflammation-driven plaque rupture—rather than gradual arterial narrowing—and reviews recent research, clinical guidelines, and practical considerations for hs-CRP testing in practice.

Key Discussion Points & Insights

1. Understanding Cardiovascular Events & Inflammation

• Not all heart attacks are due to slow artery narrowing. Most are due to the rupture of soft, unstable plaque, triggering inflammation and clot formation.
  • Metaphor:
    • "We can draw a parallel between soft plaque and volcanoes. Soft, sticky plaque is made up of cholesterol and fat, and it can erupt just like a volcano and lead to a heart attack or a stroke." (01:00 - 01:18)
• The main culprit making plaque vulnerable? Inflammation.

2. CRP vs. hs-CRP: What’s the Difference?

• CRP (C-Reactive Protein):

  • Nonspecific, acute-phase protein produced by the liver in response to injury/infection/inflammation.
  • Levels can rise up to 1000x after acute events (e.g., infections, injuries, major trauma, sepsis).
    • "CRP levels up to 50 milligrams per liter are commonly associated with viral infection or injury... after a severe infection like major traumas or sepsis, we can see CRP levels raised to about 300 milligrams per liter or even higher." (01:40 - 01:58)
  • High CRP = acute inflammation; used in diagnosing/monitoring acute phase states.

• hs-CRP (High Sensitivity CRP):

  • Specialized assay to detect chronic, mild elevations (1-10 mg/L).
  • Key ranges:
    • <1 mg/L: Low CV risk
    • 1–3 mg/L: Moderately increased CV risk
    • 3–10 mg/L: High CV risk
    • "Patients with HSCRP levels below 1 milligram per liter is considered low cardiovascular risk, while 1 to 3 milligrams per liter is considered moderately increased risk for cardiovascular disease. And any patient with an HSCRP level between 3 milligrams per liter and 10 milligrams per liter are considered at high cardiovascular risk." (02:30 - 02:56)

• Illustrative metaphor:

  • Acute CRP spike = bonfire (big, short-lived)
  • Chronic hs-CRP elevation = candle (small, long-lasting)
    • "HSCRP can be thought of more like a candle, it's not as big of a burst of a flame, but it can stay burning for much longer." (03:07 - 03:15)

3. Best Practices: hs-CRP Measurement

• Repeat test: If elevated, repeat hs-CRP in 2 weeks to rule out temporary (acute) inflammation.
  • "If you get an HS CRP and it is elevated, you want to get it repeated about two weeks later to make sure that the elevation that you're seeing isn't due to an acute event like illness or injury." (03:30 - 03:41)

4. Evidence Linking hs-CRP & Cardiovascular Events

• Consistent association between high hs-CRP and risk of:
  • Myocardial infarction (heart attack)
  • Stroke
  • Cardiovascular death

Landmark Studies:

• JUPITER Trial:

  • Statin therapy reduced CV risk in patients with high hs-CRP, even if their LDL was not elevated.
  • "This shifts the conversation from cholesterol alone to inflammation as a therapeutic target." (04:33 - 04:40)

• CANTOS Trial:

  • Lowering inflammation (hs-CRP) decreased risk, even without changing LDL cholesterol.
  • "Cardiovascular risk went down with a decrease in hscrp even though lipids stayed the same. And this really solidified that targeting and lowering inflammation lowers risk." (04:55 - 05:10)

5. Guidelines & hs-CRP in Practice

• Guideline integration:

  • AHA and ACC define hs-CRP >2 mg/L as a "risk enhancer."
  • Recommend discussing moderate-intensity statin therapy for patients with borderline/intermediate ASCVD risk and elevated hs-CRP.
    • "The AHA and the ACC consider elevated HSCRP above 2 milligrams per liter to be a risk enhancer and recommend risk Discussion Regarding moderate intensity statin therapy..." (05:34 - 05:48)

• Associated risk factors:

  • High hs-CRP often seen with:
    • Increased weight
    • Elevated BP
    • Smoking
    • Metabolic syndrome
    • Diabetes
    • Low HDL, high triglycerides
    • Hormone therapy
    • Chronic infections/inflammatory conditions
  • "These scenarios may increase your patient's risk for having high hscrp, which ultimately leaves them at greater risk of having a cardiovascular event." (06:04 - 06:11)

6. Emerging Concepts & Wellness

• Inflammaging:
  • Describes chronic, low-grade inflammation that increases with age and unhealthy lifestyle.
  • hs-CRP can be a "measurable signal" for inflammaging.
• Broader risk stratification:
  • hs-CRP best used with other biomarkers (e.g., MPO, Lp-PLA2).
  • "HSCRP can be used as a red flag and paired with other inflammatory biomarkers... to improve risk stratification and identify patients who are at greatest risk." (06:33 - 06:47)

7. Memorable Closing Metaphor

• "Understanding and addressing inflammation may be one of the most empowering and important tools that we have in our toolkit, allowing us to quiet the plaque before the volcano erupts." (06:50 - 07:00)

Notable Quotes & Moments

• Plaques as volcanoes:

  • "Soft, sticky plaque... can erupt just like a volcano and lead to a heart attack or a stroke." (01:12)

• CRP vs. hs-CRP metaphor:

  • "CRP in response to an illness or injury... we can think about this like a bonfire... HSCRP can be thought of more like a candle... it can stay burning for much longer." (03:00–03:15)

• Impact of studies:

  • "This shifts the conversation from cholesterol alone to inflammation as a therapeutic target for patients at risk for cardiovascular disease." (04:36)

• Statin guidelines:

  • "AHA and ACC consider elevated HSCRP above 2 milligrams per liter to be a risk enhancer..." (05:34)

• Empowering analogy:

  • "...allowing us to quiet the plaque before the volcano erupts." (06:55)

Key Timestamps for Important Segments

• 00:55–01:20: Plaque & volcano metaphor; what makes plaque unstable
• 01:40–02:00: Acute CRP elevations and clinical interpretations
• 02:30–02:56: hs-CRP risk thresholds explained
• 03:00–03:15: Bonfire vs. candle metaphor for acute vs. chronic inflammation
• 03:30–03:41: Recommendation to repeat hs-CRP after two weeks
• 04:20–05:20: Jupiter and CANTOS trials—impact of lowering hs-CRP
• 05:34–05:48: Integration into guidelines and clinical recommendations
• 06:33–06:47: Use of hs-CRP with other markers for risk stratification
• 06:50–07:00: Final empowering takeaway

Summary Takeaway

This episode underscores the paradigm shift in cardiovascular risk assessment: inflammation, as measured by hs-CRP, is a critical marker—sometimes independent of cholesterol—and actionable for clinical care. hs-CRP integrates into both standard and wellness medicine, helping clinicians and patients "quiet the plaque before the volcano erupts.”