Vertical auto profile
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About the VAP®+ Lipid Panel
The Vertical Auto Profile (VAP®+) Lipid Panel is the most accurate and comprehensive lipid analysis using gold standard technology to assess risk, personalize treatment and improve outcomes in patients at risk for cardiovascular disease (CVD).
The VAP® Lipid Panel was developed by Dr. Jere Segrest of the University of Alabama at Birmingham’s Atherosclerosis Research Unit in the early 1990s. In 1999, Atherotech Diagnostics – the nation’s leading cardiometabolic clinical reference laboratory based in Birmingham, AL – acquired the rights to the VAP® Lipid Panel. Since then, Atherotech has provided the VAP® Lipid Panel as the most effective technology for physicians across the United States to optimize identification, treatment and management of cardiovascular disease. In 2013, Atherotech developed the second generation of the lipid profile: VAP®+ Lipid Panel.
The VAP®+ Lipid Panel is the only commercially available panel that reports all lipoprotein parameters considered necessary by National Guidelines including American Diabetes Association (ADA), American College of Cardiology (ACC), American Association of Clinical Endocrinologists (AACE), as well as the National Cholesterol Education Program Adult Treatment Panel III (ATPIII).
Risk Categories & Treatment
The VAP®+ Lipid Panel report uses a direct measurement method to identify risk in three different categories: cholesterol-rich, triglyceride-rich and hereditary. This allows physicians to create personalized and more effective treatment programs based on a patient’s individual risk(s).
- Cholesterol-Rich: The cholesterol portion of VAP®+ Lipid Panel informs a patient of the low-density lipoprotein (LDL) cholesterol in the body and whether it should be monitored and/or treated. It also shows the amount of high-density lipoprotein (HDL) cholesterol, which travels through the bloodstream collecting up the particles of “bad” cholesterol. If a patient’s results are flagged in this area, a physician may discuss exercise, lowering the amount of fat in diet and/or prescribe treatment with a statin, resin or ezetimibe.
- Triglyceride-Rich: The triglyceride portion of the test examines the fats in the bloodstream by evaluating the remnant lipoproteins, which provide a measurement of how many extra triglyceride-rich particles are in the body. When a patient’s diet is poor, the body produces more triglycerides, causing remnant lipoproteins like very-low-density lipoprotein (VLDL) to increase. If a patient’s results are flagged in this area, a physician may discuss exercise and lowering sugars and starches in the diet. Patients may also be encouraged to add an Omega-3 fatty acid, niacin or fibrate.
- Hereditary: The hereditary portion of the test provides insight into risk factors that a patient might not be able to do anything about given family history. Lipoprotein (a) (Lp(a)) is a genetic risk marker that may put a patient at greater risk for a heart attack or stroke. While a person may not be able to change Lp(a), its presence may change the way a physician evaluates overall risk. While it may be difficult to treat Lp(a), patients may be prescribed medication, such as niacin, to lower risk.
- Other: The VAP®+ Lipid Panel also measures other components of cholesterol not evaluated by the basic lipid panel (BLP), including:
- Non-HDL Cholesterol: Non-HDL cholesterol is a potentially harmful form of cholesterol in the body. Many studies have demonstrated that non-HDL cholesterol is a better predictor of CVD risk than LDL cholesterol, especially in statin-treated patients.
- ApoB: Apolipoprotein B (ApoB) is a protein that is associated with LDL particles that may help give a more accurate picture of CVD risk, particularly for those with borderline or slightly elevated lipid levels.
- LDL Particle Number: The LDL particle number tells a patient exactly how many of the bad particles are floating around in the bloodstream, which could ultimately cause a buildup of the arterial walls. Many studies show that the LDL particle number is a better discriminator of risk than is LDL cholesterol.
Patients Who Can Benefit From the VAP®+ Lipid Panel
- Males ≥ 45 years of age or females ≥ 55 years of age
- Patients with established atherosclerotic vascular disease
- Patients with a Framingham risk score over five percent
- Patients with an inflammatory biomarker
- Patients with one of the following risk factors: cigarette smoker, diabetes/metabolic syndrome, high blood pressure, low HDL cholesterol, family history of heart disease
Recent Clinical Evidence: BLP vs. VAP®+ Lipid Panel
Currently, the basic lipid panel (BLP) is the method used for measuring a patient’s risk for CVD; however, recent clinical evidence published in the Journal of the American College of Cardiology reported that the VAP® + Lipid Panel showed up to 60 percent of patients most at risk may have been misclassified and/or undertreated from using the BLP1. This finding marks the need for a more accurate and comprehensive lipid analysis with the VAP® + Lipid Panel, which directly measures a variety of factors associated with CVD.
Other clinical evidence published in the American Heart Journal in 2009 found that 50 percent of patients hospitalized each year with CVD had “normal” cholesterol levels according to BLP results2.
The BLP’s primary responsibility is to measure LDL cholesterol levels; however, LDL cholesterol only accounts for 30 percent of the risk of premature CVD, while the remaining 70 percent represents residual risk factors not identified by the BLP. Since the BLP uses a calculated LDL measurement, levels are consistently underestimated, therefore, leading to under treatment of high-risk patients. Unlike the BLP, the VAP®+ Lipid Panel directly measures a variety of factors associated with CVD, providing a more accurate picture of a patient’s risk. In addition, because of the direct measurement patients are not required to fast prior to testing, unlike the BLP.
Cardiovascular Disease & Recent American Heart Association Guidelines
According to the American Heart Association (AHA), one in three adults in the United States has one or more types of CVD, and the number of deaths due to heart attack, congestive heart failure, congenital heart disease and stroke is far greater than other diseases3. These statistics further stress the need for primary care physicians to leverage more comprehensive and accurate diagnostic tests, such as the VAP®+ Lipid Panel, to aid in the prevention and treatment of these life-threatening diseases.
Despite ongoing research to identify new approaches to treating and managing CVD, the AHA released a new clinical practice guideline in November 2013 which stated that most patients prescribed statin therapy have the greatest chance of preventing stroke and heart attacks; however, recent studies have indicated that a significant proportion of patients may not experience the LDL cholesterol reduction expected from statins. This research stresses the need for further studies to evaluate the efficacy of statin therapy and the need for more advanced treatment options.
Given the VAP®+ Lipid Panel’s ability to directly measure multiple risk factors of CVD, the test may aid physicians in determining if a more aggressive, personalized treatment option is needed.
The VAP®+ Lipid Panel is covered by Medicare and most insurance carriers when medically necessary. In the event a patient’s health plan does not provide complete coverage, Atherotech will work with patients to achieve a reasonable and fair financial outcome.
- Martin S, Blaha, M, Elshazly, M. Friedewald-Estimated Versus Directly Measured Low-Density Lipoprotein Cholesterol and Treatment Implications. J Am Coll Cardiol. 2013
- Sachdeva A, Cannon CP, Deedwania, PC, et al. Lipid levels in patients hospitalized with coronary artery disease: an analysis of 136,905 hospitalizations in Get with the Guidelines. Am Heart J. 2009;157(1):111-117
- Roger VL, Go AS, Lloyd-Jones DM, et al; on behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics – 2011 update: a report from the American Heart Association. Circulation. 2011;123(4):e18-e209.
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