Sorted By Test Name - Mayo Medical Laboratories

C1ES
8198
Useful For: Assessment of risk of developing myocardial infarction in patients presenting with acute
coronary syndromes Assessment of risk of developing cardiovascular disease or ischemic events in
individuals who do not manifest disease at present
Interpretation: Increased high sensitivity C-reactive protein values are associated with increased risks
of cardiovascular disease or cardiovascular events.
Reference Values:
Low risk: 3.0 mg/L
Acute inflammation: >10.0 mg/L
Clinical References: 1. Haverkate F, Thompson SG, Pyke SD, et al: Production of C-reactive
protein and risk of coronary events in stable and unstable angina. European Concerted Action on
Thrombosis and Disabilities Angina Pectoris Study Group. Lancet 1997;349(9050):462-466 2. Rebuzzi
AG, Quaranta G, Liuzzo G, et al: Incremental prognostic value of serum levels of troponin T and
C-reactive protein on admission in patients with unstable angina pectoris. Am J Cardiol
1998;82(6):715-719 3. Ridker PM, Cushman M, Stampfer MJ, et al: Inflammation, aspirin, and the risk of
cardiovascular disease in apparently healthy men. N Engl J Med 1997;336(14):973-979 4. Tracy RP,
Lemaitre RN, Psaty BM, et al: Relationship of C-reactive protein to risk of cardiovascular disease in the
elderly. Results from the Cardiovascular Health Study and the Rural Health Promotion Project.
Arterioscler Throm Vasc Biol 1997;17(6):1121-1127 5. Ridker PM, Buring JE, Shih J, et al: Prospective
study of C-reactive protein and the risk of future cardiovascular events among apparently healthy women.
Circulation 1998;98(8):731-733 6. Koenig W, Sund M, Frohlich M, et al: C-reactive protein, a sensitive
marker of inflammation, predicts future risk of coronary heart disease in initially healthy middle-aged
men: results from the MONICA (Monitoring Trends and Determinants in Cardiovascular Disease)
Augsburg Cohort Study, 1984 to 1992. Circulation 1999;99(2):237-242 7. Ridker PM, Glynn RJ,
Hennekens CH: C-reactive protein adds to the predictive value of total and HDL cholesterol in
determining risk of first myocardial infarction. Circulation 1998;97(20):2007-2011 8. Ridker PM, Rifai N,
Rose L, et al: Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the
prediction of first cardiovascular events. N Engl J Med 2003;347(20):1557-1565 9. Pearson TA, Mensah
GA, Alexander RW, et al: Markers of inflammation and cardiovascular disease; application to clinical and
public health practice; A statement for healthcare professionals from the Center for Disease Control and
Prevention and the American Heart Association. Circulation 2003;107(3):499-511 10. Ridker PM,
Danielson E, Fonseca FAH, et al: Rosuvastatin to Prevent Vascular Events in Men and Women with
Elevated C-Reactive Protein. N Engl J Med 2008;359(21):2195-2207
C1 Esterase (C1ES) Inhibitor Antigen, Serum
Clinical Information: C1 esterase inhibitor blocks the activation of C1 (first component of the
complement cascade) to its active form. The deficiency of C1 esterase inhibitor results in the
inappropriate activation of C1 and the subsequent release of an activation peptide from C2 with kinin-like
activity. This kinin-like peptide enhances vascular permeability. C1 esterase inhibitor deficiency results in
hereditary or acquired angioedema. This disease is an autosomal dominant inherited condition, in which
exhaustion of the abnormally low levels of C1 esterase inhibitor results in C1 activation, breakdown of C2
and C4, and subsequent acute edema of subcutaneous tissue, the gastrointestinal tract, or the upper
respiratory tract. The disease responds to attenuated androgens. Because 15% of C1 inhibitor deficiencies
have nonfunctional protein, some patients will have abnormal functional results (FC1EQ/81493 C1
Esterase Inhibitor, Functional Assay, Serum) in the presence of normal (or elevated) antigen levels.
Useful For: Diagnosis of hereditary angioedema Monitoring levels of C1 esterase inhibitor in response
to therapy
Interpretation: Abnormally low results are consistent with a heterozygous C1 esterase inhibitor
deficiency and hereditary angioedema. Fifteen percent of hereditary angioedema patients have a normal or
elevated level but nonfunctional C1 esterase inhibitor protein. Detection of these patients requires a
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