Why Order The VAP Cholesterol Test ®

Why Order The VAP® Cholesterol Test
The VAP® Cholesterol Test is an affordable test that routinely reports direct LDL-C, non-HDL, and ApoB—the three major
risk factors identified by the American Diabetes Association/American College of Cardiology joint consensus statement and
the NCEP ATP III guidelines as targets to effectively reduce CVD risk. The VAP Test also routinely reports residual lipid risks
posed by such components as: elevated lipoprotein (a); low HDL2; small, dense LDL particles; and triglyceride rich remnants.
Accurate
The accuracy of VAP measurements are
verified by beta quantification, a standard
procedure for lipoprotein analysis based
on centrifugation.
Affordable
The VAP Test is reimbursed by most
insurance carriers, Medicare and
Medicaid. You can find out more
information by contacting Atherotech.
Easy
Because the VAP Test directly measures
all cholesterol components, including
LDL-C, fasting is not required.
Effective
By reporting 22 values of cholesterol,
the VAP Test identifies risks you can’t see
with a standard lipid panel.
Accessible
Obtaining a VAP Test is easy. Contact
your local clinical lab, or contact
Atherotech directly.
Who should get a VAP?
• Any patient with established atherosclerosis/
vascular disease
• Any patient with NCEP ATP III risk factors:
o Cigarette smoking
• Any patient with diabetes mellitus
o Hypertension
• Any patient with a Framingham risk score over 5%
o Low HDL-C (<40 mg/dL)
• Any patient with an elevated inflammatory biomarker
o Family history of premature CHD
o Age (men ≥ 45 years; women ≥ 55 years)
How to get a VAP Test
1.You can order The VAP Test directly from Atherotech by calling 877-901-8510.
2.The VAP Test is reimbursed by most insurance carriers and Medicare/Medicaid.
201 London Parkway | Birmingham, AL 35211 | 877-901-8510 | www.Atherotech.com
Patient Name: PATIENT, TEST
Sex: F
Date Drawn 03/12/09
Account: Test CLIENT
Age: 34
Date Tested: 03/12/09
Physician: Physician, Test
DOB: 10/01/1974
Accession: 6333743
Fasting Status: Fasting
Client No: CLIENTACN12345
Patient ID: 3173769
Risk
Direct-Measured Cholesterol Panel
Actual
Total LDL
162
<130 mg/dL
LDL4+3+2+1 + Lp(a) + IDL
LDL4+3+2+1
Total LDL minus Lp(a) and IDL
Desirable
Low
Description
High
128
<100 mg/dL
Lp(a)
15
<10 mg/dL
More atherogenic than LDL
IDL
19
<20 mg/dL
More atherogenic than LDL
Total HDL
56
≥40 mg/dL
HDL2 + HDL3
HDL2
13
>15 mg/dL
Large Buoyant, more protective
HDL3
43
>25 mg/dL
Small Dense, less protective
Total VLDL
24
<30 mg/dL
VLDL1+2 + VLDL3
VLDL1+2
9.8
<20 mg/dL
Buoyant VLDL, less risk
VLDL3
15
<10 mg/dL
Dense VLDL, more risk
Total Cholesterol
243
<200 mg/dL
Secondary and Emerging Risk Factors
Actual
Desirable
LDL + HDL + VLDL
Risk
Low
Description
High
Triglycerides
141
<150 mg/dL
Linked to increased risk for CHD
Non-HDL Cholesterol
187
<160 mg/dL
LDL + VLDL
Remnant Lipoproteins
34
<30 mg/dL
IDL + VLDL3
15
<10 mg/dL
More atherogenic than LDL
A/B
Pattern A
Lp(a)
LDL Density (Pattern)
B: more risk; A/B intermediate risk; A: less risk
LDL Subclasses (mg/dL) LDL4=23.7, LDL3=56.6, LDL2=22.3, LDL1=25.4
Apolipoproteins
Actual
Desirable
LDL4+3 small, dense. LDL2+1 large, buoyant
Risk
Low
Description
High
Apo B
125
<109 mg/dL
Sum atherogenic lipoprotein particles
Apo A1
161
>145 mg/dL
Sum anti-atherogenic lipoprotein particles
Apo B/A1 ratio
0.78
<0.75
Metabolic Syndrome/Insulin Resistant Assessment
Atherogenic Dyslipidemia
Physician Input Required
Triglycerides
≥150 mg/dL
Blood Pressure
≥130 / ≥85 mm Hg
HDL2
<10mg/dL males
<15mg/dL females
Fasting Glucose
≥100 mg/dL
Pattern B
Low ratio indicates lower risk
Considerations
The normal LDL target of <130mg/dL* for moderate risk patients can
be lowered to <100mg/dL* due to the presence of any of the following
ATP III emerging risks factors:
LDL Size - Dense (Pattern B)
Remnant Lipoproteins elevated
Abdominal Obesity
≥102 cm (≥40 in) male
≥88 cm (≥35 in) female
Lp(a)
* If patient is defined as very high risk LDL target of <70 mg/dL can
be considered.
Clinicians: If you have questions about test interpretation and implications for care, call (877) 519-4807 to speak with a Medical Science Consultant.
Patients: If you have had a VAP Test and are interested in nutrition and exercise instructions, call Our Healthy Heart Program at (866) 827-8378.
Note: Atherotech does not mandate or advise treatment for individual patients. Patient treatment and recommendations are the responsibility of the clinician.
Atherotech, Inc.
201 London Parkway
Birmingham, AL 35211
ATHER Revised Sample Test Results Slick_2011.indd 1
Phone: (877) 901-8510
Fax: (205) 314-7403
Lab Director: Dr. Kris Kulkarni
www.Atherotech.com
© 2011 Atherotech
V-PH1-3.2011
3/28/11 1:47:44 PM
VAP Cholesterol Test
explanations for patients
Your VAP® Cholesterol Test is a comprehensive lipid panel that shows risk factors that the routine lipid test cannot identify. Knowing these
risk factors can help your physician create a treatment plan designed to reduce your risk of heart disease. The following definitions
will help you understand each VAP measurement and what you can do to help avoid diabetes, stroke and heart disease.
Test
Test Description
Normal Values
Additional Lifestyle Suggestions
Total Low Density
Lipoprotein (LDL)
Cholesterol
(Direct Cholesterol)
Your total “bad” cholesterol. There are three
components: LDL4+3+2+1, Lp(a) and IDL.
Patient at low risk: < 160 mg/dL
Patient at moderate risk: < 130 mg/dL
Patient at high risk: < 100 mg/dL
Patient at highest risk: < 70 mg/dL (optional)
Choose: sterols and stanols, high-fiber foods
LDL 4+3+2+1
The amount of “bad” cholesterol carried by LDL
particles.
< 100 mg/dL
Choose: sterols and stanols, high-fiber foods
Lipoprotein (a)
(Lp(a))
An inherited risk factor. It is an LDL-like particle
with Velcro® -like attachment, so it sticks to the
walls of the arteries.
< 10 mg/dL
Intermediate Density
Lipoprotein (IDL)
A carrier of triglycerides that increases risk for
heart disease.
< 20 mg/dL
Choose: high-fiber foods, omega-3 fatty acids
Limit: refined carbs
Total High Density
Lipoprotein (HDL)
Cholesterol
HDL 2
HDL 3
Your “good” or “protective” cholesterol. HDL 2 is
the protective form of HDL. Its role is to act like
a garbage truck to take the “bad” cholesterol out
of circulation. HDL 3 is the least protective form
of HDL.
HDL-C (Total): > 40 mg/dL
HDL-C for Patients with Metabolic Syndrome:
> 40 mg/dL (M) > 50 mg/dL (F)
HDL 2: > 10 mg/dL (M) > 15 mg/dL (F)
HDL3: > 30 mg/dL (M) > 25 mg/dL (F)
Choose: healthy fats
Limit: refined carbs
Stop: smoking
Total Very Low Density
Lipoprotein (VLDL)
Cholesterol
VLDL1&2
VLDL 3
Another type of “bad” cholesterol produced by
the liver and the main carrier of triglycerides. It
is a marker of prediabetes. VLDL1&2 includes the
larger types of VLDL. VLDL 3 is smaller and is a
greater risk factor for heart disease.
VLDL (Total): < 30 mg/dL
VLDL1&2: < 20 mg/dL
VLDL 3: < 10 mg/dL
Choose: omega-3 fatty acids, high-fiber foods
Limit: refined carbs, alcohol
Stop: smoking
Triglycerides
Another type of fat in the blood that can come
from sugars and fats in your diet. It increases
your risk of diabetes and heart disease.
< 150 mg/dL
Choose: omega-3 fatty acids, high-fiber foods
Limit: refined carbs, alcohol
Stop: smoking
Non-HDL Cholesterol
The sum of Total LDL and Total VLDL.
Dependent upon LDL (Direct) goal (NonHDL-C goal = LDL goal + 30 mg/dL)
Choose: omega-3 fatty acids, high-fiber
foods, sterols and stanols
Limit: refined carbs, alcohol
Stop: smoking
Remnant Lipoproteins
The sum of IDL and VLDL 3.
< 30 mg/dL
Choose: omega-3 fatty acids, high-fiber foods
Limit: refined carbs, alcohol
Stop: smoking
LDL Density (Pattern)
Pattern A: large and fluffy LDL is like popped
popcorn. Pattern B: small LDL is like popcorn
kernels and can mean higher risk of heart
disease. Pattern A/B: is like a mix of popped
popcorn and popcorn kernels.
Pattern A
Choose: omega-3 fatty acids
Limit: refined carbs, alcohol
Apolipoprotein B
(apoB)
The number of “bad” cholesterol LDL and VLDL
particles. Fewer is better.
High risk: < 90 mg/dL
Highest risk: < 80 mg/dL
Choose: omega-3 fatty acids, high-fiber
foods, sterols and stanols
Limit: refined carbs, alcohol
Stop: smoking
Apolipoprotein A1
(apoA1)
The number of “good” HDL cholesterol particles
in your blood. More are better.
> 118 mg/dL (M)
> 145 mg/dL (F)
Choose: healthy fats
Limit: refined carbs
Stop: smoking
ApoB/apoA1 ratio
A ratio of the number of bad LDL cholesterol
particles to the number of good HDL cholesterol
particles. The lower the number, the lower the
risk of heart disease.
< 0.92 (M)
< 0.75 (F)
Choose: healthy fats, high-fiber foods, sterols
and stanols
Limit: refined carbs, alcohol
Stop: smoking
201 London Parkway | Birmingham, AL 35211 | 877-901-8510 | www.Atherotech.com