The VAP Test

More than half of the people who experienced a heart attack had "normal" cholesterol test results.

More Comprehensive Test
The VAP Test uses an advanced technology that provides a more accurate, individualized picture of heart disease risk, so doctors and healthcare professionals can take steps to prevent future heart attacks. The VAP Expanded Lipid Profile measures not only the basic information provided by the routine cholesterol test, but also identifies hidden cholesterol problems that can increase the risk of developing heart disease-even if routine cholesterol test results are "normal." As a result, the VAP Test was named one of "Ten Ways to Live Longer" by Forbes.com, and was selected as one of "Five Tests Worth Paying for" by The Wall Street Journal.

Clinical Need
The role of cholesterol testing in clinical practice is to stratify a patient's risk for cardiovascular disease, and to direct therapy to reduce that risk. Accuracy and comprehensiveness in cholesterol testing are critical, especially in light of lower LDL goals and the need to measure and treat a variety of cholesterol subclasses and components. In addition, the ability to provide patient-specific diagnosis and treatment are increasingly important. As a result, advanced cholesterol tests based on The VAP Test Technology are the best choice for cardiac-risk patients.

Direct-Measured LDL
One of the key benefits of the VAP Technology is a direct-measured LDL. The routine cholesterol panel, which calculates LDL using the Friedewald formula, provides only a 40% predictive value for coronary heart disease. In contrast, VAP Tests, which directly measure LDL, identify more than 90% of patients at risk for heart disease.

Based on concerns about the reliability of calculated LDL, the NCEP ATP III guidelines recommend direct LDL measurement methods unaffected by triglycerides and patient fasting. In fact, calculated LDL is significantly inaccurate in patients with heart disease or the equivalent (LDL goal <70-100 mg/dL). Calculated LDL also fails to accurately classify risk for those who most need it-patients with triglycerides >200 mg/dL.

Since we now drive LDL below 100 mg/dL commonly in clinical practice we must not utilize the estimated LDL any longer.

-Hubert Scharnagl
Clinical Institute of Medical and Chemical Laboratory Diagnostics
Medical University, Graz, Austria

Calculated lipid values may be useful for screening, but they should not be used to make clinical decisions regarding the diagnosis and management of dyslipidemia in individual patients.

-James H. Stein, M.D.
University of Wisconsin, Department of Medicine

NCEP ATP III Secondary Targets of Therapy and Emerging Risk Factors
VAP Technology also allows the measurement of NCEP ATP III secondary targets of therapy and emerging risk factors, which play a role in raising a patient's level of risk. Measuring these risk factors is key to managing atherogenic dyslipidemia, setting more aggressive LDL goals, and providing expanded indications for therapy.

• Increased remnant lipids (intermediate-density lipoprotein and small very low-density lipoprotein) are candidates for intervention, and can heighten heart disease risk substantially beyond that predicted by LDL alone.
• The "atherogenic lipid triad" of the metabolic syndrome (low high-density lipoprotein heart disease at any LDL level.
• LDL Pattern B is an indication for atherogenic dyslipidemia and the metabolic syndrome.
• Elevated lipoprotein(a) is an independent risk factor for heart disease.

Patients with abnormal screening profiles or positive family history also benefit from identification of secondary and emerging risk factors that may be used based on clinical judgment to raise a patient's risk classification, lower the target LDL goal, and/or modify the treatment plan.

Education
Atherotech offers a comprehensive education program designed to increase physician understanding and use of advanced lipid testing in clinical practice. Included are CME programs, presentations, articles, and other educational materials. Contact Atherotech for more information.

Speakers Bureau
Atherotech has assembled a group of leading cholesterol experts and clinicians in a variety of medical specialties who are available to make presentations about advanced lipid testing. For more information, please contact Atherotech, Inc.