|Heart Health Know your Risk !
Dr. Michael Kane
|Cardiovascular disease remains the number one killer of Americans today, and we all associate high cholesterol with heart disease. However, if your cholesterol levels are in the normal range do not become complacent. Half of all patients who have heart attacks have normal levels of cholesterol. It seems that other risk factors may be even more important than cholesterol.
Testing options for risk assessment.
The advance of testing includes a CT scan and other blood markers that can detect risk. I usually recommend all of these for patients so the most comprehensive evaluation can be done.
The CT Scan worth doing
Cardiac computed tomography (CT) for Calcium Scoring uses special x-ray equipment to produce pictures of the coronary arteries to determine if they are blocked or narrowed by the buildup of plaque – an indicator for atherosclerosis or coronary artery disease (CAD). The information obtained can help evaluate whether you are at increased risk for heart attack.
This CT Calcification Score Test requires a physician order (we can provide). This test will detect plaque formation in the arteries that feed the heart. The best score is 0. This test is not covered by insurance, but usually costs around $100.00
The presence of blood indicators of inflammation are strong predictive factors for determining who will develop coronary artery disease and suffer cardiac-related death.
The advanced risk factors that contribute to coronary artery disease are emerging as powerful prognostic indicators to determine risk. One or a combination of these risk factors can cause blood to thicken, become sticky and clot. They also cause inflammation of blood vessels and buildup of plaque.
Lipid Panel – Cholesterol, Triglycerides, HDL (good cholesterol), LDL (bad cholesterol) also a particle size analysis for cholesterol, the smaller LDL particles seem to be the ones most associated with plaque formation.
hsCRP –High sensitivity CRP tests are most often done for people who are in a high-risk demographic group for CVD, such as men over 50 and women over 60. They may also be carried out as part of several types of biochemical assay to test LDL, triglycerides, and other common measures of cardiovascular health to give a more complete picture of the patient’s risks.
Insulin Level – Blood sugar control and fasting insulin levels can be associated with inflammation. The higher the number the greater the risk of heart disease. Ideal is 6-8
Homocysteine a metabolic marker associated with heart disease. The higher the number the greater the risk of heart disease. Ideal is 6
Lipoprotein(a) This lipoprotein is associated with a greater the risk of heart disease and stroke. It is thought that this might be a genetic inheritance and might be worth testing those young people with family history of heart disease, even if their cholesterol is normal. Ideal less than 30.
Fibrinogen – This inflammation and blood clotting factor has been associated with increased risk for heart disease. High levels of Fibrinogen contribute to hardening of the arteries. Ideal is < 300
Myeloperoxidase, or MPO, is an enzyme that is released by white blood cells called macrophages that measures your body’s response to damaged artery walls that have become thin, cracked, and ultimately unstable due to cholesterol accumulation and inflammation.
Lp-PLA2 Activity test measures the activity (or actions) of Lp-PLA2 in the bloodstream. Lp-PLA2 is an enzyme that can assess the amount of inflammation in your arteries due to a build-up of cholesterol.
The recommendations for a more comprehensive evaluation for cardiovascular risk is something I recommend for all my patients. Once the complete evaluation is completed, we can determine what treatment strategy would be the most beneficial.