Frequently Asked Questions

Q: What is the difference between the VAP Cholesterol Test and the routine lipid panel?

A: The VAP Test provides all the information found in a routine lipid panel, plus measurements of all known cholesterol subclasses that play important roles in the development of CAD. The additional information provided by the VAP Test improves the ability to predict heart disease risk to more than 90%. It also directly measures LDL cholesterol. In contrast, the routine cholesterol test detects only about 40% of people at risk. The VAP Test also measures LDL density—important because patients with small, dense LDL have a four-fold increased risk of developing heart disease.

Q: Why is a direct measurement of LDL important?

A: The NCEP ATP III recommends that LDL be directly measured as a new feature of the guidelines. LDL is not directly measured in today’s routine lipid panels. Rather, it is calculated using the Friedewald equation: [LDL] = [total cholesterol] – [HDL] – [triglycerides/5]. Thus, calculated LDL is falsely low in patients with elevated triglycerides, and it does not correlate well in patients with diabetes, coronary disease, or other atherosclerotic diseases.

Q: How can the VAP Test help customize patient treatment?

A: The availability of more sophisticated cholesterol treatments points to broader use of the VAP Test because results will help physicians more specifically match a drug or combination of drugs with a patient’s cholesterol profile. The VAP Test’s breakdown of lipid subfractions is vital in determining appropriate treatments. For example, elevated Lp(a) doubles the risk for CAD and requires niacin, fenofibrate, estrogen, or N-3 PUFAs (fish oils). IDL is 10 times more atherogenic than LDL on a mg for mg basis and requires a statin plus niacin in combination. For more information, click here to request a free copy of “Using VAP Expanded Lipid Testing to Develop Optimal Patient Treatment Plans” by lipid expert Paul Ziajka, M.D., Ph.D.

Q: What is meant by “emerging risk factors” for heart disease?

A: The NCEP ATP III guidelines discuss a number of emerging risk factors for heart disease, including small, dense LDL and lipoprotein (a), or Lp(a). LDL is not present in the circulation as one well-defined structure; but rather it is present as a continuum of size and density. The presence of small, dense LDL quadruples the risk of heart disease compared with the same total LDL concentration present in a large, buoyant form. Lp(a) is a genetic risk factor that has been shown to be 10 times more atherogenic than LDL on a mg per deciliter basis. Thus, it is important to measure Lp(a) in patients with a family history of premature atherosclerosis. Importantly, these emerging risk factors are not measured by the routine lipid panel.

Q: Can the VAP Test detect the metabolic syndrome?

A: The “atherogenic lipid triad” of low HDL, high triglycerides, and small, dense LDL—also known as the metabolic syndrome—is described in NCEP ATP III guidelines as a widespread and underdiagnosed health problem. It is crucial to understand that atherosclerosis begins developing in these patients, and they maysuffer coronary events, before their blood sugar starts to rise. The expanded lipid panel may be superior to fasting insulin levels and glucose tolerance tests for detecting the metabolic syndrome, as well as providing a better guide to therapy.

Q: Do the NCEP guidelines point to the use of an expanded lipid panel like the VAP Test?

A: The NCEP ATP III guidelines offer new opportunities to improve the early detection and treatment of heart disease. ATP III focuses attention on the metabolic syndrome, as well as several emerging risk factors and secondary targets of therapy that are not measured with the routine lipid panel. The VAP Test allows clinicians to comply with ATP III at a cost comparable to the routine lipid panel.

Q: Are VAP Test results accurate?

A: Yes. The VAP Test is based on ultracentrifugation, the gold standard for reference lab lipid measurement. The test is processed at Atherotech’s CLIA-approved diagnostic laboratory. In addition, Atherotech has the accuracy of the VAP Test confirmed by three highly recognized lipid standardization programs—the American Association of Bioanalysts, the Northwest Lipid Research Laboratories, and the Accutest Proficiency Testing Program.

Q: Is the VAP Test cost-effective?

A: The VAP Test costs about the same as the routine cholesterol test and is reimbursed by most insurance carriers. Atherotech also accepts assignment from Medicare and Blue Cross/Blue Shield PPO. The VAP Test is commercially available, inexpensive, and resolves the inaccuracy in calculated LDL values associated with routine cholesterol panels. It greatly improves the ability to stratify risk and tailor treatment. In light of the wealth of important diagnostic information provided, a growing number of physicians are adopting the VAP Test as the new standard of care in cholesterol risk assessment.

Q: How can I incorporate the VAP Test into my practice?

A: From sample collection and shipping to billing and customer support, integrating the VAP Test into your practice is easy. All necessary items, including express shipment packaging and prepaid airbills, are supplied. A standard 5 ml venous blood draw is the required sample, which is then forwarded to Atherotech’s state-of-the-art reference laboratory for processing. The comprehensive results are generally provided within 72 hours via fax or secure website.