CVD-4. High Cholesterol Testing

The following is a list of what is included in the item above. Click the test(s) below to view what biomarkers are measured along with an explanation of what the biomarker is measuring.

Also known as: ApoE Genotype, ApoE Genotype Cardio IQ, Apolipoprotein E Genotype, Cardio IQ ApoE Genotype

Apoe Genotype

The test for ApoE is may be used in combination with other lipid tests that evaluate risk for CVD, such as cholesterol levels and lipoprotein electrophoresis. It may be used to check for and help to diagnose a genetic component to a lipid abnormality. Testing for ApoE may sometimes be ordered to help guide lipid treatment. In cases of high cholesterol and triglyceride levels, statins are usually considered the treatment of choice to decrease the risk of developing CVD. However, there is a wide variability in the response to these lipid-lowering drugs that is in part influenced by the Apo E genotype. Though appropriately responsive to a low fat diet, people with ApoE e4 may be less likely than those with ApoE e2 to respond to statins by decreasing their levels of LDL-C and may require adjustments to their treatment plans In Alzheimer's Disease - ApoE genotyping is also sometimes used as an adjunct test to help in the diagnosis of probable late onset Alzheimer's disease (AD) in symptomatic adults. It is called susceptibility or risk factor testing because it indicates whether there is an increased risk of AD but is not specifically diagnostic of AD. If a patient has dementia, the presence of ApoE4 may increase the likelihood that the dementia is due to AD, but does not prove that it is.

Guidance Statements

Method

Reviewer

Apolipoprotein A1

Apolipoprotein B

Apolipoprotein B/A1 Ratio

Also known as: Cholesterol, LDL, LDL, LDL Cholesterol, Direct, Low Density Lipoprotein

Direct LDL

The test for low-density lipoprotein cholesterol (LDL-C) is used as part of a lipid profile to predict an individual's risk of developing heart disease. The LDL cholesterol is considered the most important form in determining risk of heart disease. LDL values amy be used to monitor levels after the start of diet or exercise programs or to determine whether or not prescribing one of the lipid-lowering drugs, such as statins, would be useful.

Also known as: C-Reactive Protein, Cardio CRP, Cardio hs-CRP, CRP, High Sensitivity CRP, High-sensitivity C-reactive Protein, High-sensitivity CRP, Highly Sensitive CRP, hsCRP, Ultra-sensitive CRP

Hs Crp

A high-sensitivity CRP (hs-CRP) test may be used by itself, in combination with other cardiac risk markers, or in combination with a lipoprotein-associated phospholipase A2 (Lp-PLA2) test that evaluates vascular inflammation. The hs-CRP test accurately detects low concentrations of C-reactive protein to help predict a healthy person's risk of cardiovascular disease (CVD). High-sensitivity CRP is promoted by some as a test for determining a person's risk level for CVD, heart attacks, and strokes. The current thinking is that hs-CRP can play a role in the evaluation process before a person develops one of these health problems.

Also known as: Lipid Panel with Ratios (fasting), Lipid Profile with Ratios (fasting), Lipids

Chol/HDLC Ratio

Cholesterol, Total

Cholesterol is a waxy, fat-like substance that occurs naturally in all parts of the body. Your body needs some cholesterol to work properly. But if you have too much in your blood, it can combine with other substances in the blood and stick to the walls of your arteries. This is called plaque. Plaque can narrow your arteries or even block them. High levels of cholesterol in the blood can increase your risk of heart disease. Your cholesterol levels tend to rise as you get older. There are usually no signs or symptoms that you have high blood cholesterol, but it can be detected with a blood test. You are likely to have high cholesterol if members of your family have it, if you are overweight or if you eat a lot of fatty foods. You can lower your cholesterol by exercising more and eating more fruits and vegetables. You also may need to take medicine to lower your cholesterol.

HDL Cholesterol

LDL-Cholesterol

LDL/HDL Ratio

Non HDL Cholesterol

Triglycerides

Triglycerides are a form of fat and a major source of energy for the body. This test measures the amount of triglycerides in the blood. Most triglycerides are found in fat (adipose) tissue, but some triglycerides circulate in the blood to provide fuel for muscles to work. After a person eats, an increased level of triglycerides is found in the blood as the body converts the energy not needed right away into fat. Triglycerides move via the blood from the gut to adipose tissue for storage. In between meals, triglycerides are released from fat tissue to be used as an energy source for the body. Most triglycerides are carried in the blood by lipoproteins called very low density lipoproteins (VLDL). High levels of triglycerides in the blood are associated with an increased risk of developing cardiovascular disease (CVD), although the reason for this is not well understood. Certain factors can contribute to high triglyceride levels and to risk of CVD, including lack of exercise, being overweight, smoking cigarettes, consuming excess alcohol, and medical conditions such as diabetes and kidney disease.

Also known as: Lipoprotein A, Lp (a), Lp(a)

Lipoprotein (A)

Lipoprotein-a, or Lp(a) are molecules made of proteins and fat. They carry cholesterol and similar substances through the blood. A high level of Lp(a) is considered a risk factor for heart disease. High levels of lipoproteins can increase the risk of heart disease. The test is done to check your risk of atherosclerosis, stroke, and heart attack.

Also known as: Ion Mobility, Cardio IQ Lipoprotein Fractionation, Ion Mobility , HDL Subfractions, IDL Subfractions, LDL Subfractions, Lipoprotein Fraction, Lipoprotein Fractionation, Lipoprotein Fractionation Ion Mobility Cardio IQ, Quest Diagnostics has replaced the VAP® Cholesterol Test with Lipoprotein Fractionation, Ion Mobility, Cardio IQ™ test

HDL Large

LDL Medium

LDL Particle Number

LDL Pattern

LDL Peak Size

LDL Small

LP PLA2 ACTIVITY

Also known as: Very Low-Density Lipoprotein Cholesterol, VLDL, VLDL-C

Cholesterol, Very Low

Triglycerides

Triglycerides are a form of fat and a major source of energy for the body. This test measures the amount of triglycerides in the blood. Most triglycerides are found in fat (adipose) tissue, but some triglycerides circulate in the blood to provide fuel for muscles to work. After a person eats, an increased level of triglycerides is found in the blood as the body converts the energy not needed right away into fat. Triglycerides move via the blood from the gut to adipose tissue for storage. In between meals, triglycerides are released from fat tissue to be used as an energy source for the body. Most triglycerides are carried in the blood by lipoproteins called very low density lipoproteins (VLDL). High levels of triglycerides in the blood are associated with an increased risk of developing cardiovascular disease (CVD), although the reason for this is not well understood. Certain factors can contribute to high triglyceride levels and to risk of CVD, including lack of exercise, being overweight, smoking cigarettes, consuming excess alcohol, and medical conditions such as diabetes and kidney disease.
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The CVD-4. High Cholesterol Testing panel contains 9 tests with 26 biomarkers.

Brief Description: The CVD-4 High Cholesterol Testing panel represents the most comprehensive assessment in the series of cardiovascular diagnostics. It is designed to provide an extensive evaluation of cardiovascular risk factors, including genetic predispositions, lipid profiles, inflammatory markers, and more. This panel includes the Cardio IQ™ ApoE Genotype, Apolipoprotein A1, Apolipoprotein B, Direct LDL, hs-CRP, a Lipid Panel with Ratios, Lipoprotein (A), Cardio IQ™ Lipoprotein Fractionation, Ion Mobility, LP PLA2 Activity, and VLDL Cholesterol.

Collection Method: Blood Draw

Specimen Type: Whole Blood and Serum

Test Preparation: Fasting for at least 12 hours is required.

When and Why the CVD-4 Panel May Be Ordered

The CVD-4 High Cholesterol Testing panel is typically ordered for individuals at high risk of cardiovascular disease or those with a complex history of heart-related issues. It is particularly useful for patients seeking a detailed analysis of their cardiovascular health, including genetic factors that might influence their treatment plan. The panel is also recommended for individuals who have not achieved their lipid management goals with conventional treatments or who have a family history of cardiovascular disease, providing a deep dive into the factors contributing to their cardiovascular risk.

What the CVD-4 Panel Checks For

  • Cardio IQ™ ApoE Genotype: Identifies ApoE gene variants, which can affect cholesterol metabolism and influence an individual's response to dietary fats, providing insights into personalized dietary and treatment strategies.

  • Apolipoprotein A1 and Apolipoprotein B: Measure levels of proteins associated with HDL and LDL cholesterol, offering insights into the balance of protective vs. atherogenic lipoproteins in the blood.

  • Direct LDL: Provides an accurate measurement of LDL cholesterol levels, crucial for assessing cardiovascular risk and guiding lipid-lowering therapy.

  • hs-CRP: A marker of inflammation, elevated levels of which are associated with an increased risk of cardiovascular events.

  • Lipid Panel with Ratios: Assesses total cholesterol, HDL, LDL, triglycerides, and important ratios, providing a comprehensive overview of lipid health.

  • Lipoprotein (A): Elevated levels of Lp(a) are an independent risk factor for cardiovascular disease, particularly atherosclerosis.

  • Cardio IQ™ Lipoprotein Fractionation, Ion Mobility: Offers detailed analysis of lipoprotein particle size and density, further refining cardiovascular risk assessment.

  • LP PLA2 Activity: Measures the activity of an enzyme associated with vascular inflammation and plaque instability, adding another layer to cardiovascular risk profiling.

  • VLDL Cholesterol: Evaluates VLDL levels, which are important for understanding triglyceride transport and potential plaque buildup in the arteries.

Conditions Detected by the CVD-4 Panel

The CVD-4 High Cholesterol Testing panel can help detect and manage several conditions:

  • Atherosclerosis: Detailed lipid profiles, including particle size and genetic predispositions, help in assessing the risk and progression of plaque buildup in the arteries.

  • Genetic Lipid Disorders: The ApoE genotype test can identify genetic variations that influence lipid metabolism, aiding in the diagnosis of familial hypercholesterolemia and other genetic lipid disorders.

  • Inflammatory Cardiovascular Conditions: Markers like hs-CRP and LP PLA2 Activity provide insight into the role of inflammation in cardiovascular disease, guiding anti-inflammatory treatment strategies.

Using CVD-4 Panel Results in Treatment and Monitoring

Healthcare professionals utilize the CVD-4 High Cholesterol Testing panel results to:

  • Personalize Treatment Plans: Incorporating genetic information and detailed lipid analysis allows for tailored dietary, lifestyle, and pharmacological interventions.

  • Monitor Therapy Efficacy: Regular testing can assess the effectiveness of treatment regimens and the need for adjustments, particularly in patients with complex lipid disorders or those at high cardiovascular risk.

The CVD-4 High Cholesterol Testing panel offers an unparalleled depth of analysis for assessing cardiovascular risk, incorporating genetic, lipid, and inflammatory markers. This panel is invaluable for individuals with significant cardiovascular risk factors, a history of heart disease, or those seeking a detailed understanding of their cardiovascular health. By providing a holistic view of cardiovascular risk factors, the CVD-4 panel enables healthcare providers to devise personalized and effective treatment strategies, ultimately leading to better patient outcomes and reduced risk of cardiovascular events.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

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