Quantimetrix Corporation

Personalized CVD risk assessment by Lipoprint

There has been much confusion lately about the new cholesterol treatment recommendations for primary and secondary ASCVD risk management. Lipoprint® Lipoprotein Subfractions Testing System by Quantimetrix, Redondo Beach, CA, creates clarity by providing more comprehensive analysis for more specific treatment. The new cholesterol treatment guidelines weigh heavily on non-lipid risk factors, raising concerns of under-treatment of some individuals that may be at risk and overtreatment of low risk individuals based on well established risk factors such as LDL-C, Apo B and new emerging lipid and lipoprotein risk factors such as Non-HDL cholesterol or the atherogenic small dense LDL subfractions. Coronary artery disease (CAD) continues to be the leading cause of death in most of the developed countries and much of the developing world in spite of more risks awareness and increased treatment of individuals at risk. The role of lipids and lipoproteins in atherogenesis has been demonstrated by numerous studies but the methods for assessing CAD risk have continued to be the subject of much debate. Until recently, LDL cholesterol (LDL-C) was accepted as the primary target for CAD treatment. The ACC/AHA Task Force released new guidelines in November 2013 along with a new CVD risk calculator based on data from randomized control trials. The risk calculator weighs heavily upon non-lipid risk factors reducing the role of LDL-C and other dyslipidemias as risk factors. A recent study1 suggested that blood cholesterol and LDL-C levels as currently measured may not reflect the actual risk of CAD since many individuals that develop CAD have the same levels as those that do not develop CAD. These findings suggest that dyslipidemia, as currently defined, may not be a good indicator of CAD risk. The most common lipid disorder associated with CAD is a pro-atherogenic dyslipidemia characterized by the presence of highly atherogenic small dense LDL particles, intermediate density lipoproteins and VLDL remnants particles that may not be reflected by measuring total cholesterol, LDL-C or any other single metric. Recent studies suggest that pro-atherogenic dyslipidemias can be best identified by measuring the individual atherogenic lipoprotein such as VLDL remnants, IDL and the small dense LDL subfractions. The study randomly selected 22 individuals who were tested for CVD risk using the new ASCVD risk calculator. In addition, the samples were tested by other traditional and non-traditional test methods such as LDL-C, NMR LDL particle number, total cholesterol, triglycerides, non-HDL cholesterol, total cholesterol to HDL-C ratio and LDL-C to HDL-C ratio. The samples were also analyzed using the Lipoprint Lipoprotein Subfractions Testing System that can discriminate atherogenic from non-atherogenic LDL subfractions. The results of the study showed significant discordance between the various test methods. Based on the ASCVD risk calculator, 7 (31.8%) of the 22 individuals were at high risk of CVD. Five of the seven samples were classified high risk based on non-lipid risk factors such as hypertension, diabetes and advanced age and only 2 were classified high risk due to dyslipidemias. The Lipoprint LDL test measures VLDL remnants, IDL and small dense LDL subfractions in addition to the non-atherogenic large buoyant LDL. Based on the Lipoprint LDL subfractions test, 15 (68.2%) of the individuals were classified intermediate or high risk. The study suggests that the ASCVD risk calculator appears to underestimate the risk associated with dyslipidemias when compared to other test methods while the Lipoprint® LDL subfractions test captures all the high-risk individuals identified by the other methods in the study. The Lipoprint LDL subfractions test provides a more individualized assessment of CVD risk than the generalized approach of the ASCVD risk calculator. Considering the fact that CVD is a life long progressive disease, early recognition is very important in primary prevention and treatment of individuals at risk. For more information about Lipoprint, contact Quantimetrix @ quantimetrix.com 1. You can read the entire study @: http://quantimetrix.com/wp-content/uploads/Quantimetrix_AACC-2014_Lipoprint_poster.pdf

(Pictuerd) Nehenias Muñiz, Director of Electrophoresis, Quantimetrix Corporation