These blood tests help to determine your risk for coronary artery disease and guide your treatment.
Lipoprotein a (Lp(a))
Goal values:
- Desirable level for adult: less than 30 mg/dl
Preparation:
Blood should be collected after a 12-hour fast (no food or drink, except water). For the most accurate results, wait at least 2 months after a heart attack, surgery, infection, injury or pregnancy to check this blood level.
Lp(a) is LDL (low density lipoprotein) attached to a protein called apo (a). It is not fully known what Lp(a) does, but if Lp(a) is greater than 30 mg/dl, it is related to an increased risk for heart attack and stroke. It is also related to development of fatty matter in vein grafts after bypass surgery, coronary artery narrowing after angioplasty and increased risk for the development of blood clots. If Lp(a) is high, it is even more important to bring the LDL levels down to an acceptable level. Lp(a) is higher in African Americans. The causes of high Lp(a) are kidney disease and certain family (genetic) lipid disorders.
Apolipoprotein A1 (Apo A1)
Goal values:
- Desirable level for adult: more than 123 mg/dl
Preparation:
Blood should be collected after a 12-hour fast (no food or drink, except water). For the most accurate results, wait at least two months after a heart attack, surgery, infection, injury or pregnancy to check this blood level.
Apo A1 is the major protein of HDL. Low levels of Apo A1 is associated with a diet high in fat and smoking and may lead to early heart and blood vessel disease.
Apolipoprotein B (ApoB)
A major protein found in cholesterol particles. New research suggests ApoB may be a better overall marker of risk than LDL alone.
Goal values:
Preparation:
Blood should be collected after a 12-hour fast (no food or drink, except water). For the most accurate results, wait at least two months after a heart attack, surgery, infection, injury or pregnancy to check this blood level.
Apo B is a major protein found in cholesterol particles. New research suggests ApoB may be a better overall marker of risk than LDL alone.
Homocysteine (Hcy)
An amino acid. High levels are related to early development of heart and blood vessel disease
Goal values:
Preparation
This test may be measured any time of the day without fasting. For the most accurate results, wait at least two months after a heart attack, surgery, infection, injury or pregnancy to check this blood level.
Homocysteine is a common amino acid (one of the building blocks that make up proteins) found in the blood. High levels of homocysteine are related to the early development of heart and blood vessel disease. In fact, it is considered an independent risk factor for heart disease. High homocysteine is associated with low levels of vitamin B6, B12 and folate and renal disease. While it is recommended that people get enough folic acid and vitamins B6 and B12 in their diet, there have been conflicting studies about the benefits and risks related to treatment of elevated homocysteine levels with folic acid and B vitamin supplements. Therefore, ask your doctor before taking these supplements.
Fibrinogen
A protein found in the blood. Encourages blood clotting but high levels are linked to an increased risk for heart attack
Goal values:
Preparation
Blood should be collected after a 12-hour fast (no food or drink, except water). For the most accurate results, wait at least two months after a heart attack, surgery, infection, injury or pregnancy to check this blood level.
Fibrinogen is a protein found in the blood that is necessary for blood clotting. High levels of fibrinogen may be an independent risk factor for vascular disease, especially fibrinogen levels greater than 350 mg/dl. Higher blood pressure, body weight, LDL and age are related to higher levels of fibrinogen. On the other hand, alcohol use and exercise are related to lower fibrinogen levels. Higher fibrinogen levels are also seen with African Americans, and a rise is seen with menopause.
Ultra Sensitive C-reactive Protein
US-CRP, also called high sensitivity CRP.
Goal values:
- Less than 1.0 mg/L = Low Risk for CVD
- 1.0 – 2.9 mg/L = Average Risk for CVD
- Greater than 3.0 mg/L High Risk for CVD
(levels above these ranges indicate increased risk for heart and blood vessel disease)
Preparation
This test may be measured any time of the day without fasting.
C-reactive protein measures an inflammatory response in the body. In some cases, inflammation in the arteries may play a role in heart disease. Research is showing promising results for testing CRP (along with other risk factors) to determine heart disease risk in those with undetected heart disease and risk of complications for those who have already had a heart event (such as a heart attack). This test should not be ordered during times of acute inflammation.
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Global Risk Score (GRS)
Goal values:
- Less than 10% = low risk
- 10 – 20% = intermediate risk
- Greater than 20% = high risk
A tool that looks at a person’s risk factors, weighs them in importance and then gives a percentage risk of that patient developing heart disease or of having a heart attack within the next 10 years
