C-Reactive Protein, hs (CRP)

Inflammation (swelling) of the arteries is a risk factor for cardiovascular disease. It has been linked to an increased risk of heart disease, heart attack, stroke, and peripheral arterial disease. To see if your arteries are inflamed as a result of atherosclerosis, doctors can test your blood for C-reactive protein (CRP). The body produces CRP during the general process of inflammation. Therefore, CRP is a “marker” for inflammation, meaning its presence indicates an increased state of inflammation in the body.

CRP and Cardiovascular Disease Risk
In studies involving large numbers of patients, CRP levels seem to be correlated with levels of cardiovascular risk. In fact, CRP seems to predict cardiovascular risk at least as well as cholesterol levels do. Data from the Physicians Health Study, a clinical trial involving 18,000 apparently healthy physicians, found that elevated levels of CRP were associated with a threefold increase in the risk of heart attack. In the Harvard Women’s Health Study, results of the CRP test were more accurate than cholesterol levels in predicting coronary problems. Twelve different markers of inflammation were studied in healthy, postmenopausal women. After three years, CRP was the strongest predictor of risk. Women in the group with the highest CRP levels were more than four times as likely to have died from coronary disease, or to have suffered a nonfatal heart attack or stroke. This group was also more likely to have required a cardiac procedure such as angioplasty (a procedure that opens clogged arteries with the use of a flexible tube) or bypass surgery than women in the group with the lowest levels.

How Is CRP Measured?
CRP is measured with a simple blood test, which can be done at the same time your cholesterol is checked. One such test is the highly-sensitivity C-reactive protein (HS-CRP, also called ultra-sensitive CRP or US-CRP) test.
Risk is determined based on your test results.

It’s important to note that inflammation due to other conditions, such as an infection, illness, or a serious flare-up of arthritis, can raise CRP levels. Before getting the CRP test, tell your doctor what other medical conditions you have.

Cardiovascular Health

The cardiovascular system is sometimes called the blood-vascular or simply the circulatory system. It consists of the heart, which is a muscular pumping device, and a closed system of vessels called arteries, veins, and capillaries. As the name implies, blood contained in the circulatory system is pumped by the heart around a closed circle or circuit of vessels as it passes again and again through the various “circulations” of the body.

As in the adult, survival of the developing embryo depends on the circulation of blood to maintain homeostasis and a favorable cellular environment. In response to this need, the cardiovascular system makes its appearance early in development and reaches a functional state long before any other major organ system. Incredible as it seems, the primitive heart begins to beat regularly early in the fourth week following fertilization.

The vital role of the cardiovascular system in maintaining homeostasis depends on the continuous and controlled movement of blood through the thousands of miles of capillaries that permeate every tissue and reach every cell in the body. It is in the microscopic capillaries that blood performs its ultimate transport function. Nutrients and other essential materials pass from capillary blood into fluids surrounding the cells as waste products are removed.

Numerous control mechanisms help to regulate and integrate the diverse functions and component parts of the cardiovascular system in order to supply blood to specific body areas according to need. These mechanisms ensure a constant internal environment surrounding each body cell regardless of differing demands for nutrients or production of waste products.

Homocysteine Lab Test Information

Homocysteine (pronounced homo-SIS-teen) is an amino acid and is found normally in the body. Its metabolism is linked to that of several vitamins, especially folic acid, B6, and B12. Deficiencies of those vitamins may cause elevated levels of Homocysteine.

Homocysteine is a building block for the production of proteins in the body. However, elevated levels of Homocysteine are associated with premature vascular disease. Studies have shown that increased homocysteine levels can dramatically increase your risk of heart disease, stroke, peripheral vascular disease and clotting disorders. Fortunately, high homocysteine levels may be reduced with dietary vitamins folate, B6 and B12. High homocysteine levels are seen in renal disease, heart failure, and B12 or folate deficiency. Homocysteine levels also tend to increase with age. Low levels are associated with diets high in fruits and vegetables (especially those high in B vitamin and folate). An ideal homocysteine levels is less than 9 micromol/liter.

In recent years, studies have accumulated suggesting that a high level of homocysteine increases a person’s chance of developing heart disease, stroke, and peripheral vascular disease (a reduced blood flow to the hands and feet).

In September 1995, the National Heart, Lung, and Blood Institute (NHLBI) convened a special panel to review the scientific evidence about homocysteine’s possible link to heart disease. The information that follows is based on the panel’s conclusions.

Briefly, the panel said that an elevated homocysteine level appears to increase the risk of heart disease, stroke, and peripheral vascular disease. However, no studies have been done to show that lowering the homocysteine level reduces the risk of heart disease. The panel stressed that more research, especially a clinical trial, must be done to understand the possible association between the level of homocysteine and heart and related diseases.

Homocysteine & Heart Disease

Various studies have found that persons with elevated levels of homocysteine in their blood are at an increased risk of heart and vessel disease. These studies include the Physicians’

Health Study, the Tromso Study from Norway, the Framingham Heart Study, and a meta-analysis of nearly 40 studies. Some studies indicate that persons with elevated homocysteine levels tend to also have other risk factors for heart disease, especially smoking, high blood pressure, and high blood cholesterol.

So far, no clinical trial has been done to show that lowering homocysteine levels alters the progression of heart disease, or prevents heart attacks or strokes.

Why Homocysteine?

Much more basic research must be done before scientists understand how an elevated homocysteine level affects the development and progression of heart disease. However, scientists have several theories: First, a high level of homocysteine may be involved with the process called atherosclerosis, the gradual buildup of fatty substances in arteries.

Homocysteine also may make blood more likely to clot by increasing the stickiness of blood platelets. Clots can block blood flow, causing a heart attack or stroke. Increased homocysteine may affect other substances involved in clotting too. Finally, higher homocysteine levels may make blood vessels less flexible–and so less able to widen to increase blood flow. However, none of theories has so far been proven.

What Determines Homocysteine Levels?

Individuals differ in their levels of homocysteine. Two key factors affect a person’s homocysteine level–genetics and environment.

Genetics

Genetic factors help regulate the level of homocysteine in the blood. For instance, genetic flaws (mutations) can affect homocysteine’s metabolism. The NHLBI Family Heart Study found families with genetic mutations in the enzymes involved in homocysteine metabolism.

The NHLBI Framingham Heart Study and other investigations have found a relationship between elevated homocysteine levels and families with early heart disease.

Environment
The level of homocysteine in the blood also is affected by the consumption of vitamins, especially folic acid, B6, and B12.

Data from the Framingham Heart Study show that only 30-40 percent of the population was getting 200 or more micrograms of folic acid in their diet. The data indicated that for many persons an intake of at least 400 micrograms was needed to keep homocysteine levels from becoming elevated.

Data also indicate that homocysteine levels are higher in older persons than younger ones and in women after menopause than in those before. But more research is needed to confirm and explain these differences.

NMR LipoProfile

What is the NMR LipoProfile®

The NMR LipoProfile® test is an advanced cardiovascular diagnostic test that uses nuclear magnetic resonance (NMR) spectroscopy to uniquely provide rapid, simultaneous and direct measurement of LDL particle number and size of LDL particles, as well as direct measurement of HDL and VLDL subclasses.  This detailed lipoprotein particle information allows clinicians to make more effective individualized treatment decisions than previously possible based on standard lipid panel testing. The atherosclerotic culprit is LDL particle number, not LDL cholesterol.

Why should I use the NMR LipoProfile test?

You should use the NMR LipoProfile test because it provides a more accurate picture of cardiovascular (CVD) risk than the standard lipid panel.

SmokerTest

The “SmokerTest®” offers you:
* detection of lung cancer before the appearance of any clinical sign or radiological procedures;
* faster diagnosis in the presence of an isolated symptom;
* follow-up of the illness during treatment;
* post-treatment relapse watch, before any clinical signs.

All this through the expert utilization of a panel of four tumor-markers, with a blood sample. This panel includes the CEA, CA 125, NSE, Cyfra 21-1; plus the Comprehensive Metabolic-14 panel with glucose, kidney & liver panels and electrolytes TUMOR MARKERS are substances that can be detected in higher-than-normal amounts in the blood, of some patients with certain types of cancer. These substances are produced either by the tumor itself or by the body in response to the presence of cancer or certain benign (non-cancerous) conditions.
These molecules (tumor markers) occurring in blood or tissue are associated with cancer; their measurement or identification is useful in patient diagnosis or clinical management. Our panel of 4 tumor-markers is of the greatest interest for an early diagnosis.

The CEA:
the first discovered tumor marker, the CEA is still largely used, in particular in lung cancer. Slight to moderate CEA elevations (rarely above 10 ng/ml) occur in 15-30% of benign diseases of the intestine, the pancreas, the liver and the lungs: liver cirrhosis, chronic hepatitis, pancreatitis, ulcerative colitis, Crohn’s disease, emphysema. Smokers also have elevated CEA values.

The CA 125:
mainly used in the ovarian cancer, it’s also interesting in lung cancer when associated with other tumor markers. Slight to moderate elevations have been reported in individuals with non-malignant conditions such as cirrhosis, hepatitis, endometriosis, first trimester pregnancy, ovarian cysts, and pelvic inflammatory disease. Elevations during the menstrual cycle have also been mentioned. Non-ovarian malignancies include cervical, liver, pancreatic, lung, colon, stomach, biliary tract, uterine, fallopian tube, breast and endometrial carcinomas.

The NSE:
largely used in the small cells lung cancer, where marked increase is noticed ; its use with the Cyfra 21 in lung cancer treatment monitoring is of the utmost importance. NSE concentrations (inf 12 ng/ml) have been found in patients with benign pulmonary diseases and cerebral diseases. Moderate elevations are reported in cerebrovascular meningitis, disseminated encephalitis, spinocerebellar degeneration, cerebral ischemia and infarction, intracerebral hematoma, head injuries, inflammatory brain diseases, organic epilepsy, schizophrenia, and Jakob-Creutzfeld disease.

The Cyfra 21-1:
indifferent to histological type, CYF 21 is the panmarker for lung cancer because of its sensitivity which reaches 63% compared to 27% for CEA, 15% for SCC, 16% for NSE. Together with this sensitivity, CYF’s exceptional specificity reaches 95%, and the readings are directly in proportion to the phase of the illness; the mean serological values increase progressively from contained to metastatic : CYFRA is the most stunning marker ever found. Not performed in the US, this marker is largely used in Europe and Japan for the epidermoidis forms of lung cancer.
Slightly elevated values (up to 10 ng/ml) are rarely found in marked benign liver diseases and renal failure. The Cyfra21-1 is not available in the US, but largely used by top teams in Europe and Japan. For full benefit of patients.

Negative results
Warning : a negative result NEVER means that you are not carrying an EARLY stage of cancer, but simply that there is no detectable cancer by biology at this time : it’s good news for you nevertheless. Positive results
A distinctly positive result on one particular marker, or better on several, means that you will receive a commentary drawing your attention to the possibility of illness, and suggesting an immediate visit to your doctor (we will contact him if you so request).

Abnormal results
A moderately high marker rate could suggest all kinds of benign conditions together with a more serious condition. A visit to your doctor would be essential in order to clarify the matter.

Record of results
It would be very useful to your doctor to have a record of your results should a cancer have been detected. In order to be able to judge the effectiveness of a specific treatment (your doctor may have to change it from time to time), it is important to have the starting values and the follow-up values of the appropriate marker(s) concerning the type of cancer being treated. We therefore recommend regular SmokerTest®.  Analysis by CancerSafe® who will keep all your results in a medical file: YOUR medical file. Your file is protected by your own password and you can access it at any time. Once you have opened your file, you can E-mail or save your results in HTML format.

Values of tumor markers :
Normal range Moderate High values
CEA ng/ml               <8                     8-15             15-100,000
CA 125 U/ml          <35                   35-50             50-50,000
NSE ng/ml             <21                   21-40                40-4000
CYF21-1 ng/ml     <3.5                  3.5-5.0              5.0-1000

VAP Cholesterol Test

The VAP® (Vertical Auto Profile) Test is the most accurate and comprehensive cholesterol test available today, measuring 15 separate components of blood cholesterol as opposed to three in a standard test. This more comprehensive test can identify more than twice the number of lipid abnormalities (the #1 risk factor of heart disease) than the standard four component test, and is the only cholesterol test to identify markers for Metabolic Syndrome, a precursor for diabetes. Risks of both Heart Disease and Diabetes can be reduced with the right preventative treatments, which is why more accurate diagnosis is critical. The VAP Test is developed by Atherotech, Inc., a cardio-diagnostic company, and is the first cholesterol profile to comply with updated recommendations calling for more accurate, direct low-density lipoprotein (LDL) measurement which is unaffected by triglycerides. Included in Forbes.com’s list of “Ten Ways to Live Longer” and named one of “Five Tests Worth Paying For” by the Wall Street Journal, the VAP Cholesterol Test is available through national and regional diagnostic laboratories.

COMPARISON: Standard Lipid profile vs VAP Cholesterol panel

Standard Lipid Profile

*Measures total cholesterol

*Measures HDL

*Calculates LDL using the Friedewald formula (LDL = TC – HDL – TRIG/5)

*Measures triglycerides

*Requires fasting

The VAP Cholesterol Test

*Directly measures total cholesterol

*Directly measures HDL and separates into HDL2 and HDL3 (HDL2 is the “best” cholesterol and when low, is a risk factor for CAD, HDL3 is the least protective HDL)

*Directly measures LDL and separates into 3 components: LDL-R; Lp(a); and IDL (Total LDL may be normal, but one of the 3 coponents of LDL may be elevated and indicate a risk for CAD. Lp(a) is a genetic risk factor that, when elevated, could indicate a higher risk for heart disease. IDL is also a genetic risk factor.)

*Measures LDL pattern density. (Pattern A indicates large, buoyant LDL particles. Pattern B indicates small, dense
LDL particles and is most atherogenic).

*Directly measures triglycerides.

*Directly measures triglyceride-rich lipids: VLDL (1,2,3 and total) (VLDL 3 is small, dense and most dangerous).

*Fasting not required. ATPIII requires expanded lipid test when triglycerides > 400mg/dL and suggests direct measured LDL in non-fasting state.

What is the PLAC® Test?

The PLAC Test is a blood test that measures the level of Lp-PLA2 (Lipoprotein-associated Phospholipase A2), an enzyme associated with the inflammation of your arteries. Increased levels of Lp-PLA2 increase your risk of having a heart attack or stroke.

How is the PLAC Test different from other heart and stroke tests my doctor may order?

In most adults, cholesterol causes a fatty deposit called plaque to build up in the walls of the arteries. When arterial walls become inflamed, your body produces the enzyme Lp-PLA2. If the amount of Lp-PLA2 is high, this may indicate that the plaque is more likely to rupture through the inside lining of your artery into your bloodstream, where it may cause a clot that could result in heart attack or stroke.

The PLAC Test can provide you and your doctor with information about the health of your arteries that was not available in the past.

Why might my doctor order the PLAC Test for me?

When you have an infection in a cut, the cut becomes inflamed and hurts! Your arteries do not have the same type of pain receptors, and are unlikely to hurt when they are inflamed. The PLAC Test measures an enzyme that increases when your arteries are inflamed. That is why the PLAC Test can help your doctor better understand what is happening in your arteries, and assess your risk for heart attack and stroke.

Your doctor probably has ordered other tests for you such as cholesterol and is ordering the PLAC Test to gain more specific information about your health, and to help identify the best course of treatment for you.

If your PLAC Test is high, you are at increased risk for heart attack or stroke.

Now is the time to work with your doctor. Your doctor may prescribe lifestyle changes, such as exercise or diet. Your doctor may also order prescription medication, or medicine you can buy without a prescription. Remember, your arteries do not hurt when they are inflamed—you may have problems without knowing it. Over 50% of people who have a heart attack or stroke have no symptoms until the heart attack or stroke occurs.

It is important that you follow your doctor’s directions! Following the treatment plan your doctor recommends can significantly reduce your risk of a heart attack or stroke.

If your PLAC Test is low, you are at lower risk for heart attack or stroke.

In a study from the Mayo Clinic, 95% of individuals who had Lp-PLA2 levels below 200 ng/mL did not have either a heart attack or stroke over a 4-year period, even though they had coronary artery disease.