Test Results 101

LDL IIIa+b, LDL IVb – Small LDL Particles The small LDL particles, LDL IIIa+b and LDL IVb, can cause plaque build-up to progress much faster because they enter the artery wall more easily than larger LDL particles Having too many small LDL particles is a powerful risk factor for a heart attack Certain medications, proper nutrition, and regular exercise can help your body produce fewer small LDL particles

HDL2b – Large HDL Particle The larger HDL2b particles help clean the arteries by picking up cholesterol Low levels of HDL2b can increase your risk for heart disease Certain medications, weight loss with exercise, and stopping tobacco use are some ways to improve HDL2b levels

ApoB – LDL Particle Number ApoB is a direct measurement of the number of lipoprotein particles, including LDL (“bad cholesterol”), IDL, and VLDL A high apoB number indicates increased risk for heart disease Certain medications, improved eating habits, increased physical activity, and loss of body fat are some ways to improve apoB

Lp(a) Extended Range High levels of Lp(a) are associated with increased risk of cardiovascular disease and stroke Lp(a) is inherited. Diet and exercise have limited to no effect on lowering Lp(a), however certain medications can lower levels

Homocysteine High levels of homocysteine can cause injury to blood vessel walls,  increasing your risk for heart disease and stroke Nutrition, such as increasing intake of folate-rich foods, plays an important role in reducing levels of homocysteine

Lp-PLA2 – Inflammation in the Artery High levels of Lp-PLA2 can predict risk of a heart attack or stroke When both Lp-PLA2 levels and systolic blood pressure are high, stroke risk increases significantly Certain medications can reduce levels of Lp-PLA2

CRP (hs) – Inflammation in the Body High levels of C-Reactive Protein (CRP) indicate inflammation due to infection or tissue injury If both CRP and Lp-PLA2 levels are high, your risk for a heart attack or stroke increases significantly Certain medications and food may have anti-inflammatory benefits

Fibrinogen – Inflammation Marker and Clotting Factor Fibrinogen is a part of the blood’s clotting process and can be elevated due to inflammation Continual high levels are linked to an increased risk for heart disease Fibrinogen levels can be lowered by stopping tobacco use and losing excessive body fat

Insulin – Hormone Insulin is released from the pancreas to regulate blood sugar (glucose) levels Constant high levels are linked to an increased risk for heart disease, diabetes, and other health conditions High insulin levels can be improved with proper nutrition, exercise, stress management, or certain medications

NT-proBNP – Stress on the Heart NT-proBNP is a hormone released from heart muscle cells in response to ongoing stress or strain on the heart A high level of NT-proBNP is a warning signal that your heart is being overworked The early identification of high levels may help your physician decide on a treatment plan to lower the risk of a heart disease event

Vitamin D – Hormone Low Vitamin D levels are linked to an increased risk of heart disease, stroke, diabetes, hypertension, and heart failure Vitamin D levels may be low for many reasons, such as insufficient sun exposure, eating diets poor in Vitamin D, and obesity If levels are too low, your physician may recommend Vitamin D supplements

Omega-3 – Fatty Acid Low Omega-3 fatty acid levels are linked to an increased risk of cardiovascular disease, including sudden cardiac death Omega-3 levels may be low due to eating diets poor in Omega-3 fatty acids If levels are low, your physician may recommend Omega-3 supplements and/or increased consumption of foods high in Omega-3 fatty acids

4q25-AF Risk Genotype The 4q25-AF Risk Genotype Test can give insight into your risk for atrial fibrillation (irregular heart beat) and risk for stroke caused by atrial fibrillationa People who are 4q25-AF Risk carriers may have a higher risk for atrial fibrillation (AF) and stroke caused by AFb

9p21 Genotype Test The 9p21 Genotype Test can give insight into your risk for certain types of heart disease People who are 9p21 carriers may have a higher risk of a heart attack before the age of 60 years in women and 50 years in men, abdominal aortic aneurysm (AAA), or blocked coronary arteries or a heart attack at any agec

ApoE Genotype Test The ApoE Genotype Test can give insight into your heart disease risk as well as your response to different amounts of dietary fats There are 6 ApoE genotypes:  2/2, 2/3, 3/3, 2/4, 3/4, and 4/4 People who have the 3/4 or 4/4 genotype may have a higher risk of heart disease

CYP2C19 Genotype Test The CYP2C19 Genotype Test can give insight into how your body processes the medication clopidogrel (Plavix®)d For people who are Poor or Intermediate Metabolizers, Plavix may be less effective at preventing blood clotse For people who are Ultra-Rapid Metabolizers, Plavix may be overly effective, which may increase the risk of a bleeding probleme

KIF6 Genotype Test The KIF6 Genotype Test can give insight into your heart disease risk as well as your response to the statin medications atorvastatin (Lipitor®) and pravastatin (Pravachol®) People who are KIF6 carriers may have a higher risk of heart disease events (such as a heart attack)f However, for people who are KIF6 carriers, the statin medications atorvastatin (Lipitor) or pravastatin (Pravachol) may help reduce this riskg

LPA-Aspirin Genotype Test The LPA-Aspirin Genotype Test can give insight into your risk for heart disease as well as your response to aspirin People who are LPA-Aspirin carriers may have a higher risk of heart disease events (such as a heart attack)h However, for people who are LPA-Aspirin carriers, low-dose  aspirin may help reduce this riski

LPA-Intron 25 Genotype Test The LPA-Intron 25 Genotype Test can give insight into your risk for heart disease People who are LPA-Intron 25 carriers may have a higher risk of heart diseasej

Plavix is a registered trademark of Sanofi-Aventis Corporation. Lipitor is a registered trademark of Pfizer. Pravachol is a registered trademark of Bristol-Myers Squibb.

The 4q25-AF Risk, 9p21, ApoE, CYP2C19, KIF6, LPA-Aspirin, and LPA-Intron 25 Genotype Tests were developed and their performance characteristics were determined by Berkeley HeartLab, Inc., a CLIA-certified and CAP-accredited laboratory. They have not been approved or cleared by the U.S. FDA.

a. Association with AF and cardioembolic (CE) stroke was found and replicated in Caucasian and Han Chinese study populations.

b. Being a carrier of this genetic risk factor does not mean that you will develop AF or CE stroke. Similarly, patients who are noncarriers of this genetic risk factor are not immune to these heart disorders. 

c. Heart attacks (both before the age of 60 in women and 50 in men and at any age) and blocked coronary artery study populations consisted of Caucasian men and women with history of heart attacks.  Abdominal aortic aneurysm (AAA) study populations consisted of Caucasian men and women with history of arterial disease and type-2 diabetes.  9p21 has been found to be associated with risk of AAA, but not rate of aneurysmal expansion or risk of rupture.

d. The clinical impact of the CYP2C19 genotype on the metabolism of specific drugs will vary based on non-genetic factors such as liver and kidney status, other medications used (including over-the-counter medications, herbals, and other supplements) alcohol or illegal drug use, race, age, weight, diet, and diseases present in an individual.

e. Clinical outcomes data was performed in primarily Caucasian patients with unknown coronary syndrome undergoing dual antiplatelet treatment (for Poor Metabolizers) and patients with coronary artery disease and planned drug eluting stent replacement (for Ultra-Rapid metabolizers). 

f. In published studies about KIF6, heart disease events included but were not limited to heart attack, stroke, and plaque build-up in the coronary arteries requiring stent placement.  Study populations predominantly consisted of Caucasians 45 years of age and older.

g. The benefit of statin therapy has only been observed with atorvastatin and pravastatin therapy.  Other studies of simvastatin and rosuvastatin indicate that this benefit is not generalizable to all statins.

h. Study populations predominantly consisted of Caucasians 45-79 years of age.  LPA-Aspirin carrier frequency was approximately 4% in the Caucasian population.  

i. In the published study, aspirin therapy was studied with low dose (100 mg) aspirin taken orally on alternate days.  The data in this study are limited to initially healthy Caucasian women, and the number of cardiovascular events among LPA-Aspirin carriers was modest.

j. Study populations predominantly consisted of Caucasian men and women in Europe.  LPA-Intron 25 carrier frequencies are approximately 2% in African Americans and Mexican Americans, and less than 1% in East Asian populations.