Rapamycin and hsCRP

#1

Hi all,
Still somewhat new to this group. I am a 59 y/o woman with single vessel CVD and a sirolimus coated stent placed 1.5 years ago. Historically my hsCRP was elevated 2-slightly over 3. These were drawn in 2012 and 2015 and I was unaware of the results. I was always considered low risk for cardiac disease as I have had a lipid panel most CVD patients would be jealous of at baseline. I’m now on rosuvastatin 20mg and 81ASA and taking rapa 2-4 q 3-4 weeks (I am limited by apthous ulcers for the past 8 months. My pre-rapa hsCRP got way down to 0.7 and I was super happy about that. Take a bunch of anti-inflammatory supplements as well. I can list if anyone interested (I do have a medical background).

As an important aside, I had a partial knee replacement last Dec so it’s been 9 months. My knee is still painful at times and continues to swell periodically, not what I or my orthopedic surgeon was expecting at this point.
My bloodwork this week showed my hsCPR was 4.2!!
My LDL is 48.
All my other labs were great for where I need to be.

Can anyone comment about the elevated hsCRP? Has this happened to anyone remote from a surgery? Can I just related this to my low level continue knee inflammation? the number is freaking me out.
thanks

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#2

The knee inflammation would cause a CRP increase, possibly all the increase you see, but you dont have enough measurements to know.

#3

Thanks John, how do you mean I don’t have enough measurements to know? Are you referring to repeated hsCRP’s? Other labs?

#4

Repeated crp ideally before the operation and then soon afterwards.

#5

My approach in general, is tests should result in some action point. If there is no action point as a result of result X vs. Y then why test.

So you have a knee that is still inflamed. That is unfortunate. Testing your CRP probably has no action point.

Work on the knee inflammation and once that is settled down and you have no other reason for a CRP to be elevated, a HsCRP has meaning for vascular risk. It however has no useful role at the point you have a clear source of something that is increasing the level.

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#6

My hsCRP was very high (>10) 2 years ago when I was at 5mg rapa, vs now at 1.5 at 12mg rapa, which is still high, but better.

hsCRP can be high for so many reasons. For me, when I have an autoimmune flareup… it goes off the charts. And yes, it is definitely possible your knee swelling contributes to this number.

once your swelling is down, it makes sense to look at it.

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#7

2 months before it was 0.7. I do not have one in the early post-op period because theoretically there would be no point.

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