Atherotech VAP cholesterol test meets updated ADA, ACC measurement and treatment guidelines for high risk patients

Apr 22 2008

The determination of LDL, non-HDL and apoB are now recognized as valid, accurate and recommended methods of guiding and achieving the best treatment goals for patients with cardiometabolic risk (CMR).

The VAP(R) Cholesterol Test (Atherotech, Inc.) is the only commercially available advanced lipid profile that routinely reports all three lipoprotein parameters considered necessary by recent expert consensus guidelines (ADA-ACC).

Patients with Type 2 diabetes are at increased risk of CMR and cardiovascular disease due to several factors, including lipoprotein abnormalities identified through cholesterol testing. Because many patients with CMR (including Type 2 diabetics) have relatively normal levels of LDL, the American Diabetes Association (ADA) convened a consensus conference in association with the American College of Cardiology (ACC) and has issued updated guidelines for the measurement of lipoproteins such as LDL, HDL, non-HDL and apoB in CMR patients.

"Doctors treating patients with cardiometabolic risk now have clear guidelines to follow, including specific treatment targets for non-HDL and apoB that are individualized to the magnitude of risk," said Atherotech Chief Medical Officer James Ehrlich, M.D. "The VAP Test is the only comprehensive lipid profile out there that routinely addresses and is compliant with both existing NCEP ATP III guidelines and the new ADA-ACC consensus statement."

The consensus statement confirms the importance of apoB, articulates its relationship to non-HDL and gives specific recommendations on treatment targets and managing residual risk. In addition to supporting existing (National Institutes of Health) NIH guidelines for LDL measurement and treatment, the ADA-ACC consensus panel recommends the calculation of non-HDL cholesterol on all lab reports to determine cardiovascular disease risk in CMR patients with low to moderate LDL levels and the calculation of apoB in patients with CMR who are on medication. As published in Diabetes Care, the ADA-ACC consensus document also acknowledges the value of directly measured LDL levels when triglyceride levels exceed 200, a frequent occurrence in CMR patients. Extending beyond previous guidelines to specifically address the issue of cardiometabolic risk, the new statement advises clinicians to measure and treat apoB to goal: apoB below 80 (mg/dl) for the highest risk patients or apoB below 90 for high risk patients.

Of note is the fact that the consensus document experts specifically favor apoB, which is considered internationally as the "best reflection of atherogenic particle burden" and does not currently recommend the measurement of nuclear magnetic resonance (NMR) derived LDL-P primarily because of a dearth of clinical evidence and questions about its validity among various ethnic groups. The report also acknowledges that more aggressive control of other lipoprotein parameters may be warranted in those with high concentrations of Lp(a), a particle that is measured in all VAP samples.

The VAP (Vertical Auto Profile) Test is the most accurate and comprehensive cholesterol test available today, reporting 15 separate components of blood cholesterol as opposed to four in a standard test, and is the only cholesterol test to identify markers for Metabolic Syndrome, a precursor for diabetes.

The VAP Test provides physicians with direct measurement of LDL, HDL, and all clinically relevant subclasses, and includes non-HDL, a highly accurate determination of apo B, emerging risk factors (such as Lp(a), LDL pattern, density and size) and precise calculations for LDL components. The test helps to clearly identify individuals with cardiometabolic risk and is able to identify far more patients at risk for heart disease than the standard cholesterol test.