Blood Tests to Determine Risk of Coronary Artery Disease


Blood and urine lab tests are used to find out your risk of heart and blood vessel disease. The results, along with your health history, help your health care team create the best plan of care for you.

Total cholesterol (TC)

Why is the total cholesterol test important?

  • Directly linked to your risk of heart and blood vessel disease.

Goal for patients who are:

  • 20 years old or younger: 75-169 mg/dL
  • 21 years old or older: 100-199 mg/dL

Your goal may be different depending your your age and other risk factors you have.

Triglycerides (TG)

Why is the triglycerides test important?

  • Related to heart and blood vessel disease.
  • A very high (>500-1,000 mg/dL) increases your reisk of pancreatitis.
  • Levels are higher if you have obesity or diabetes.
  • Eating simple sugars/simple carbohydrates, a high-fat diet and drinking alcohol can cause high levels.
  • Exercise can help lower levels.

Goal: Less than 150 mg/dL

High-density lipoprotein (HDL)

Why is the high-density lipoprotein (HDL) test important?

  • “Good cholesterol”
  • High levels reduce your risk of heart and blood vessel disease. The higher your HDL level, the better.

Ideal levels:

  • Men: Higher than 45 mg/dL
  • Women: Higher than 55 mg/dL

Low-density lipoprotein (LDL)

Why is the low-density lipoprotein test important?

  • LDL is bad cholesterol.
  • High levels are linked to a greater risk of heart and blood vessel disease.
  • Major treatment target for patients taking cholesterol-lowering medications


  • Less than 70 mg/dL if you have heart or blood vessel disease, diabetes or a very high risk of heart disease.
  • Less than 100 mg/dL if you have metabolic syndrome or more than one risk factor for heart disease.
  • Less than 130 mg/dL if you have a low risk of coronary artery disease.

Complete blood count with differential (CBC)

Why is a complete blood count with differential important?

  • Blood tests to get information about the parts of your blood, such as red blood cells, white blood cells and platelets.
  • Help detect diseases and how bad they are.
  • Detect anemia (low red blood cell counts).

Normal ranges:

  • White blood cell count: 5,000-10,000
  • Hematocrit (amount of blood made up of red cells): Men 40- 55%, Women 36-48%.
  • Hemoglobin (part of red blood cell that carries oxygen): Men 14-18 gm/dL, Women 12-16 gm/dL.

Lipoprotein (a) [(Lp(a)]

Why is the lipoprotein (a) [Lp(a)] Important?

  • Lp(a) is low-density lipoprotein (LDL) attached to a protein called apo (a).
  • High levels of Lp(a) increase your risk of heart attack, stroke, blood clots, fatty build-up in veins after coronary artery bypass surgery and narrowing of the coronary arteries after angioplasty.
  • High levels tend to run in families.
  • Your doctor may order this test if you have a family history of heart disease at an early age.
  • If your level is high, your doctor will likely be aggressive in managing your heart disease risk factors, especially your LDL level.

Ideal level: Less than 30 mg/dL

Apoliprotein B (ApoB)

Why is the apoliprotein B (ApoB) test important?
  • A major protein found in cholesterol.
  • Research suggests ApoB may be a better overall marker of risk than LDL alone.
  • High levels of ApoB are a sign of small, dense LDLs.

Ideal level: Less than 100 mg/dL

Homocysteine (Hcy)

Why is the homocysteine (Hcy) test important?

  • An amino acid.
  • High levels increase your risk of heart and blood vessel disease.

Ideal Level: Less than 10 umol/L

Hemoglobin A1c (HgA1c)

Why is the hemoglobin A1c (HgA1c) Important?

  • Used to diagnose diabetes.
  • Reflects average blood sugar levels over the last 2-3 months.


  • Ideal level: 5.6 or lower
  • Prediabetes: 5.7-6.4
  • Diabetes: 6.5 or higher
  • Goal for people with diabetes: Less than 6.5-7

Fasting glucose (also called fasting blood sugar)

Why is the fasting glucose test important?

  • High levels can mean you have diabetes or are insulin-resistant.

Goal Values:

  • Ideal level: less than 100 mg/dL
  • Prediabetes: 110-125 mg/dL
  • Diabetes: 126 mg/dL or higher on two separate tests


Why is the insulin test important?

  • Insulin is a hormone made by the pancreas to control blood sugar.
  • High levels are associated with obesity, high cholesterol levels, diabetes, heart and blood vessel disease, and stroke.

Normal range: 1-24 U/ml

Creatine Kinase (CK)

Why is the creatine kinase (CK) test important?

  • A muscle enzyme.
  • Levels may be higher if you take medication to lower cholesterol levels.

Normal Range: 30-220 U/L

Alanine Amino-transferase (ALT) also called SGPT

Why is the Alanine Amino-Transferase (ALT) test important?

  • A liver enzyme.
  • Levels may be higher if you take medication to lower cholesterol.

Normal Range: 5-45 U/L

Aspartate Trans-aminase (AST) (also called SGOT)

Why is the Aspartate Trans-Aminase (AST) test important?

  • A liver enzyme.
  • Levels may be higher if you take medication to lower cholesterol.

Normal Range: 7-40 U/L


Why is the Fibrogen test important?
  • A protein in the blood.
  • Helps blood clot, but too much increases your risk of a heart attack.

Ideal range: Less than 300 mg/dL

Thyroid stimulating hormone (TSH)

Why is the thyroid stimulating hormone (TSH) test important?

  • Related to how well your thyroid is working.

Ideal Range: 0.4-5.5 uU/mL

Ultra-sensitive C-reactive protein (us-CRP) (also called high-sensitivity CRP)

Why is the ultra-sensitive C-reative protein (us-CRP) test important?

  • Indicates vascular inflammation.
  • Higher levels mean a higher risk of heart and blood vessel disease.


  • Low risk: Less than 2.0 mg/L
  • Intermediate risk: 2-3 mg/L
  • High risk: Higher than 3.0 mg/L

Urine albumin creatinine ratio (U Alb:Cr)

Why is the urine albumin creatinine ratio (U Alb:Cr) test important?

  • Detects protein in the urine.
  • A small amount of protein in the urine is a risk factor for heart and blood vessel disease.

Ideal Level: Less than 30 mg/g


Why is the MPO test important?

  • Indicates inflammation.
  • High levels are linked to a higher risk of heart attack, stroke and the need for coronary artery bypass surgery.
  • High levels can also mean cardiovascular disease is getting worse.
  • If your levels are high, your doctor will probably be aggressive to reduce your risk of cardiovascular problems.

Ideal level: Less than 350 mg/g

Vitamin D

Why is the vitamin D test important?

  • Fat-soluble vitamin.
  • D3 Cholecalciferol.
  • Vitamin D controls the calcium and phosphate levels in your body. Calcium and phosphate keep the bones healthy.
  • Low levels of Vitamin D are linked to various health risks. Low levels can also mean you are having trouble tolerating a statin.

Normal Range: 31-80 ng/ml

Trimethylamine N-oxide (TMAO)

Why is the trimethylamine N-oxide (TMAO) test important?

  • Comes from bacteria in your gut.
  • High levels are found in meat, eggs and dairy foods.
  • Taking choine, lecithin, L-carnitine and other supplements can cause high levels of TMAO.
  • High levels in the blood increase the risk of heart disease, heart attack, stroke and clogged arteries (atherosclerosis).
  • If your levels are high, your doctor will likely be aggressive to lower your LDL and other risk factors, have you take low-dose aspirin twice a day, and have you follow a Mediterranean diet.


  • Low risk: Less than 6.2 uM
  • Intermediate Risk: 6.2 - 9.9 uM
  • High risk: 10.0 uM or higher

Aminoterminal, pro-brain natriuretic peptide (NT-proBNP)

Why is the aminoterminal, pro-brain natriuretic peptide (NT-proBNP) test important?

  • Protein made in the heart and found in the blood when there is extra strain on the heart.
  • High levels are linked to a higher risk of heart and blood vessel disease and may mean there is a decrease in heart function. You may need other tests to get more information.
  • If your levels are high, your doctor will likely be aggressive to reduce your risk of cardiovascular problems

Ideal level: Less than 125 pg/mL

Serum creatinine (CR)

Why is the serum creatinine (CR) test important?

  • Related to kidney function.

Normal Ranges:

  • Women: 0.058-0.96 mg/dL
  • Men: 0.73-1.22 mg/dL

Global risk score (GRS)

Why is the global risk score (GRS) test important?

  • A tool to rate your risk of developing heart disease or of having a heart attack within the next 10 years.


  • Low risk: Less than 10%
  • Intermediate risk: 10-20%
  • High risk: 20% or higher


If you need more information, click here to contact us, chat online with a nurse or call the Miller Family Heart, Vascular & Thoracic Institute Resource & Information Nurse at 216.445.9288 or toll-free at 866.289.6911. We would be happy to help you.

Last reviewed by a Cleveland Clinic medical professional on 09/30/2019.

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