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The Benefits of the VAP Test


Please see related story: A Personal Awakening
Read information about Linus Pauling
Information about Vitamin C
A Lipoprotein Risk Assessment Test for Informed Cholesterol Management
The Benefits of the VAP Test Comprehensive lipoprotein analysis
Who is a candidate for a VAP Test? Risk Factors
RETURN TO HEART TECHNOLOGY PAGE

The Benefits of the VAP Test's comprehensive lipoprotein risk assessment:

PHYSICIAN: Comprehensive lipoprotein information allows you to identify more patients with abnormal lipid risk factors than with routine cholesterol tests, including some individuals with normal total cholesterol. And you can make more informed therapy drug choices based on your more specific lipid information and better monitor patient progress.

PATIENT: Comprehensive lipoprotein analysis improves patient awareness of risk and treatment. Thereby allowing for improved patient compliance with therapy.

COMPONENTS OF THE VAP TEST include direct measured LDL, HDL, VLDL, TC with TG and LDL/HDL RATIO and TC/HDL RATIO. Additional important lipoprotein risk factors include:

Lp(a): The "heart attack" cholesterol. A direct risk factor for CAD and high levels are a predictor of stroke and post angioplasty restenosis in many cases.

HDL2: The "best" cholesterol. Low HDL2 is a risk factor for CAD in patients with normal cholesterol.

HDL3: The least protective HDL. TC/lipid panel don't distinguish between HDL2and HDL3

IDL: "Bad" non-LDL cholesterol. Independent risk factor for CAD.

VLDL3: A predictor of the severity of CAD. The most dense (bad) element of triglyceride.

Pattern A, B or A/B: "A" is the (good) atherogenic of the LDL subclasses, "B" is an independent risk factor for CAD—the most atherogenic (bad) of the HDL sub classes and "A/B" is intermediate in atherogenicity.

Background

Conventional cholesterol tests were adopted during the 1970's and 1980's. With the success and rapid adoption of the new cholesterol lowering drugs in the mid 1990's came the clinical understanding that cholesterol risk assessment and treatment went well beyond high TC and LDL.

Clinical data from all significant studies confirm the fact that the majority of atherogenic lipoproteins (cholesterol) are not detected with routine cholesterol tests. And that appropriate treatment most often requires a comprehensive lipoprotein risk assessment that includes atherogenic subclasses.

Total cholesterol in humans is distributed primarily among three major lipoprotein classes: very low-density lipoproteins (VLDL), LDL and HDL.

Smaller amounts of cholesterol are contained in two minor lipoprotein classes: intermediate density lipoprotein (IDL) and lipoprotein (a) [Lp(a)]. IDL and Lp(a) are themselves atherogenic and on average, their concentrations can be expected to be higher in patients with CAD and in individuals at risk for developing CAD by virtue of a dyslipoproteinemia. Inversely, low-levels of HDL subclass HDL 2 increase the risk of CAD even when patients have normal HDL profiles.

Common total cholesterol (TC), LDL, HDL, and triglyceride tests fail to provide and report the potentially atherogenic contributions of IDL, Lp(a) and HDL2. Routine cholesterol measurements are calculated, not measured. The current gold standard for determining CAD risk is the Friedewald equation ([LDL] = [TC] – [HDL] –[TG]/5). For this reason, "several" potentially atherogenic particles are actually present but masked with the common cholesterol measurement.

Quantification of LDL and HDL subclasses has been considered appropriate for epidemiological studies by the NIH but they determined the information as not readily available (1995), too costly, time consuming and lacking clinical utility as no lipid specific drugs were available. For this reason physicians and health care providers continued the use of the clinically marginalized Friedewald equation for measuring TC, HDL and calculating LDL well into the 1990's.

Limitations of the routine Friedewald method include:
Fails to identify pattern A,B or A/B
Fails to identify familial dyslipidemias, which accounts for up to 85% of premature CAD.
Failure to identify type III hyperlipoproteinemia.
Errors in LDL calculated from the Friedwald equation increase as triglycerides increase above 200 mg/dcl.
Fails to identify Lp(a), HDL2,HDL3, IDL and VLDL3.

The Solution

The VAP Test information, until the introduction of cholesterol-lowering drugs, had a narrow practical application. Today with these drugs and more on the way, the VAP Test profile is extremely useful for a broad physician, patient base and to drug companies who benefit from the availability of comprehensive cholesterol information. The VAP technology bridges the significant diagnostic information gap between routine total cholesterol (TC) and lipid panel tests and the comprehensive lipoprotein information required to maximize detection of cardiovascular arterial disease (CAD) in the largest possible patient population.

The VAP test identifies more patients at risk for CAD as do routine cholesterol screens and identifies significantly more individuals at risk for premature CAD. VAP information enables health care providers to make more informed decisions when choosing drugs and monitoring treatment. Information that historically has been considered cost prohibitive and non-reimbursable for large-scale uses. The medical disciplines include cardiac, diabetes, women's health, obesity and family practice medicine.


Please see related story: A Personal Awakening
Read information about Linus Pauling
Information about Vitamin C
A Lipoprotein Risk Assessment Test for Informed Cholesterol Management
The Benefits of the VAP Test Comprehensive lipoprotein analysis
Who is a candidate for a VAP Test? Risk Factors
RETURN TO HEART TECHNOLOGY PAGE

 
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Last Updated: 08-17-02 by SJM