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Blood tests to determine your risk of CAD
These blood tests help to determine your risk for coronary artery disease and guide your treatment.
Lipoprotein a (Lp[a]): Researchers do not yet know all the functions of Lp(a), but if a patient's level is greater than 30 mg/dl he or she has a greater risk of suffering a heart attack or stroke. An elevated level of Lp(a) also is linked to the development of fatty matter vein grafts after bypass surgery, to coronary artery narrowing after angioplasty, and to the development of blood clots.
Target value:
Less than 30 mg/dL
Preparation:
Blood should be collected after a 12-hour fast (no food or drink, except water). For the most accurate results, wait at least two months after a heart attack, surgery, infection, injury, or pregnancy.
Apolipoprotein A1 (Apo A1): Apo A1 is the major protein of HDL. Low levels are associated with a diet high in fat and smoking and may indicate the risk of early heart and blood vessel disease.
Target value:
More than 123 mg/dL
Preparation:
Blood should be collected after a 12-hour fast (no food or drink, except water). For the most accurate results, wait at least two months after a heart attack, surgery, infection, injury, or pregnancy.
Apolipoprotein B (ApoB): This protein is found in cholesterol particles. Recent research suggests ApoB may be a better overall marker of risk than LDL alone.
Target value:
Less than 100 mg/dL
Preparation:
Blood should be collected after a 12-hour fast (no food or drink, except water). For the most accurate results, wait at least two months after a heart attack, surgery, infection, injury, or pregnancy.
Homocysteine (Hcy): High levels of homocysteine are associated with an increased risk of cardiovascular disease. Both folic acid and B vitamins naturally break down homocysteine in the blood. While treatment with folic acid and B vitamins have not been shown to clearly reduce the risk of cardiovascular disease, it is recommended that people get enough folic acid and vitamins B-6 and B-12 in their diet. Supplements can be used when one's diet does not provide enough of these nutrients.
Target value:
Less than 10 umol/L
Preparation
This test may be measured any time of the day without fasting. For the most accurate results, wait at least two months after a heart attack, surgery, infection, injury, or pregnancy.
Fibrinogen: This blood protein is necessary for clotting. High levels may be an independent risk factor for cardiovascular disease. Higher blood pressure, excess body weight, elevated blood levels of LDL, diabetes, and advancing age are linked to higher levels of fibrinogen. Alcohol use and exercise are related to lower fibrinogen levels.
Target value:
Less than 300 mg/dL
Preparation:
Blood should be collected after a 12-hour fast (no food or drink, except water). For the most accurate results, wait at least two months after a heart attack, surgery, infection, injury, or pregnancy.
Ultra Sensitive C-reactive protein (US-CRP, also called high sensitivity CRP):
The presence of this protein in the blood indicates a heightened state of inflammation in the body. Inflammation is the body's normal response to physical problems such as fever, injury, and infection. In addition, studies show that elevated CRP correlates with increased risk for heart attack, stroke, peripheral vascular disease, and reclosing of coronary arteries after angioplasty. For now, clinical guidelines do not recommend a routine CRP test for those with no indication of heart disease.
For those with elevated US-CRP, low-dose aspirin (100 mg or less) daily may provide protection from cardiac disease. Statin drugs, which lower LDL, also seem to reduce US-CRP levels. Do not begin taking these medications for high US-CRP levels without speaking with your physician.
Target values:
Less than 1.0 mg/L—low risk for heart and blood vessel disease
1.0-2.9 mg/L—average risk for heart and blood vessel disease
Greater than 3.0 mg/L—high risk for heart and blood vessel disease
Preparation:
Blood can be drawn for this test any time of the day without fasting. This blood test hould not be done in individuals who have had an illness or infection, especially if they have had a fever.
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