Cardiovascular Disease
Atherosclerosis is the condition in which the artery wall thickens as the result of the buildup of fatty material such as cholesterol. Management of atherosclerosis is an integral part of clinical practice.
Historically, clinicians manage a patient's risk for cardiovascular disease by measuring plasma lipids such as LDL-C, HDL-C and triglycerides. More recently, it's been shown that measurement of lipoprotein particles, the containers that carry cholesterol, may be beneficial for patient management.
Among cardiometabolic risk (CMR) patients, about two-thirds have high Low Density Lipoprotein particle number (LDL-P) despite optimal levels of LDL-C. For cardiometabolic risk patients, LDL-P should be considered as a primary goal of therapy due to its stronger association with cardiovascular risk.1
Help manage patients with clarity and confidence with LDL-P by NMR.
1. Rosenson et al. Atherosclerosis. 2010; 213:1-7
Pathway to CVD
It is lipoproteins that interact with the arterial wall and set in motion the cascade of events that leads to atherosclerosis. Measurements of cholesterol are indirect estimates of the number of lipoproteins that transport the bulk of cholesterol in plasma and are the most atherogenic.1
Ideal candidates for measuring LDL particle levels are cardiometabolic risk patients whose LDL-C levels are optimal, near optimal or borderline high. These include patients with known cardiovascular disease, metabolic syndrome or Type 2 Diabetes, low HDL-C, overweight/obese or have a family history of heart disease.
LDL particles move into the arterial intima in a gradient-driven process. The rate of passive diffusion is increased when the concentration of circulating LDL particles is increased. Once inside the intima, LDL particles bind to proteoglycans and initiate a process whereby the LDL particles are modified and taken up by macrophages to form foam cells resulting in progression of the atherosclerotic lesion. Cholesterol molecules are just “passengers” but the particles drive atherosclerosis.1,2
Because of variability in the amount of cholesterol carried in LDL particles, frequent disagreement occurs between LDL-C and LDL particle number (LDL-P).2 Among high cardiometabolic risk patients with LDL-C <100 mg/dL, about two-thirds of patients have high LDL particle concentration (LDL-P).3
In 2008, the American College of Cardiology (ACC) and the American Diabetes Association (ADA) issued a consensus statement that supported the value of LDL particle number measurement as a better discriminator of risk than LDL cholesterol, based on results from cross-sectional and prospective studies. The consensus statement also mentions that some studies suggest that LDL particle number by NMR may be a better index of CVD risk than LDL cholesterol or non-HDL cholesterol and more reliable index of on-treatment residual risk.1
With a simple blood test, LipoScience offers a CVD management tool with actionable results.
1. Brunzell et al. JACC. 2008;15:1512-1524. 2. Contois et al. Clin Chem. 2009;55(3):407-419. 3. Rosenson et al. Atherosclerosis (2010), doi:10.1016/j.atherosclerosis.2010.03.038. 4. Cromwell et al. Curr Cardiol Rep 2009;11:468-475.
Case Studies
Our case studies represent patients with conditions contributing to cardiometabolic risk and have been provided by clinicians who use the NMR LipoProfile® test routinely in their practices. Results from our laboratory show approximately 30% of our population exhibit a discordance between LDL-C and LDL-P. These case studies are for informational purposes only and not for diagnostic use. Click on a link below for a PDF of the full case study.
Meet Dan, Age 60: Hypertension and Dyslipoproteinemia
Risk Factors: On Therapy, T2DM and Dyslipidemia. Currently on Lipitor® 20, ACTOplus met® 15/850mg, Altace® 5mg, Toprol XL® 50mg
Meet Kathy, Age 56: Type II Diabetes and Hypertension
Risk Factors: Type II diabetes and hypertension. Currently on Simvastatin 80mg, Metformin, Zestoretic
Meet Bryan, Age 46: Family History
Risk Factors: Family History. Father died of MI at age 49, Premature ASHD
Clinician Resource Program - Share and gather case study information on real patients. LipoScience offers a free case study resource program for clinicians. Whether you want to share an interesting case study, or ask an expert about management options for your patients, the Clinician Resource Program provides this opportunity by offering a free, one-on-one peer teleconference. To speak with an expert about the NMR LipoProfile test, please contact inquiries@liposcience.com.
How to Submit Samples for Testing
When referring samples to LipoScience, there are three options.
Option 1
Send directly to LipoScience. If you've received your first request for the test and would like to set up a send out relationship with us, call Client Services at (877) 547-6837 to open an account.
Results can be mailed, faxed, or provided online, depending on your preference.
Click here to view our sample preparation instructions.
Click here for Centrifuge Insert Instructions.
Samples should be shipped via FedEx. FedEx Shipping Instructions
- Call FedEx 1-800-463-3339
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Option 2
Order through your local lab provider. LipoScience has formed relationships with many national and regional laboratories to offer the test. If you'd prefer, contact your laboratory services provider and ask them to send the test to us.
Option 3
Establish a relationship with LipoScience. We would like to work with your laboratory to offer the test as a send out at contracted rates. As a laboratory client, you will have access to advanced training programs, sales literature, clinical forums and local sales support. For details, please call Client Services at (877) 547-6837, or email inquiries@liposcience.com.
Understanding the Results
With a simple blood test, LipoScience offers a CVD management tool with actionable results.
The following strategy1 may assist you in integrating LDL-P into clinical practice and address therapeutic options available to meet recommended targets of therapy.
Step 1: Determine Cardiovascular Risk Category
Determine your patient's cardiovascular risk based on clinical history and risk factors such as BMI, blood pressure, sex, age, etc. and assign them to an appropriate risk category based on your clinical judgment.
Step 2: Define Goals of therapy for the degree of risk present
Based on your cardiovascular risk assessment and information from laboratory tests, determine appropriate goals for your patient.
Step 3: Consider therapeutic lifestyle changes and medications if necessary
Once at LDL-C goal, integration of LDL-P in the patient management plan may be considered.
Improved diet and exercise is an important part of a patient's overall heart health and may lower LDL particle number. LipoScience developed a resource based on the well documented Mediterranean diet, with easy exercise tips, to help your patients adopt a heart healthy lifestyle. Click here to download the brochure.
Step 4: Assess response to therapy and modify intervention as needed
If therapeutic changes are made, repeat the NMR LipoProfile test to evaluate response to therapy and to determine if your patient has met their goals of therapy.
1. Cromwell et al. Curr Cardiol Rep 2009;11:468-475.
Clinician Resource Program - Share and gather case study information on real patients. LipoScience offers a free case study resource program for clinicians. Whether you want to share an interesting case study, or ask an expert about management options for your patients, the Clinician Resource Program provides this opportunity by offering a free, one-on-one peer teleconference. To speak with an expert about the NMR LipoProfile test, please contact inquiries@liposcience.com.
Online Results
FOR PHYSICIAN AND LABORATORY USE ONLY
As a service to our physician and laboratory clients, we offer the convenience of accessing test results online. To access the results, you will need a user ID and password. If you would like to set up an account to receive results online, please email inquiries@liposcience.com, or call 1-877-547-6837.
We are unable to provide laboratory results directly to patients.
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Patient information may only be accessed by LipoScience employees authorized to do so as part of job-required activities. Additionally, all personal patient data resides at LipoScience behind firewalls that operate on separate LipoScience servers. The general public has no access to these servers.
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If you have any questions, please call Client Services toll-free at 1-877-547-6837.