To help determine your risk of developing cardiovascular disease (CVD), including your risk of coronary heart disease (CHD) and ischemic stroke
Lp-PLA2
When your healthcare provider determines that you are at a moderate to high risk of developing CVD or of having an ischemic stroke; when you have a family history of CVD or CHD
A blood sample drawn from a vein in your arm
None
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How is it used?
The Lp-PLA2 test is sometimes used to help evaluate a person's risk of developing coronary heart disease (CHD) or to help determine the risk of having an ischemic stroke.
Lp-PLA2 is an enzyme that appears to play a role in the inflammation of blood vessels and is thought to help promote atherosclerosis. Some recent studies have shown that Lp-PLA2 is an independent risk marker for cardiovascular disease (CVD), including CHD and ischemic stroke.
The test would typically be used to evaluate an individual who is at a moderate to elevated risk for CHD or stroke, someone with one or more other risk factors. For instance, it may be ordered when someone has normal or minimally elevated lipid levels, borderline high blood pressure (hypertension), or metabolic syndrome.
An Lp-PLA2 test may sometimes be used along with an hs-CRP test to evaluate a person's level of underlying inflammation associated with CVD risk. However, unlike hs-CRP, the Lp-PLA2 test is not affected by conditions other than CVD that can cause general inflammation, so it may be used when someone has an inflammatory condition, such as arthritis.
Lp-PLA2 is a relatively new test that is not frequently ordered and its full clinical usefulness has yet to be established. It is intended to give additional information, not to replace cholesterol and other lipid level testing.
Some researchers are exploring whether treatment to lower Lp-PLA2 levels will lower a person's risk of CHD and ischemic stroke. However, several studies on drugs that inhibit Lp-PLA2 activity (such as darapladib) found that inhibition had little or no effect on reducing risk of CHD. If future studies found the risk of CVD and stroke is decreased when Lp-PLA2 is lowered, then the Lp-PLA2 test may be ordered more frequently and be used to monitor a person's response to treatment.
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When is it ordered?
Lp-PLA2 is a relatively new test that is not frequently ordered. Some healthcare practitioners may order it along with other cardiac risk markers when someone has a family history of CHD, has metabolic syndrome, and/or is considered to be at a moderate to elevated risk for CHD or ischemic stroke.
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What does the test result mean?
A significantly elevated Lp-PLA2 level indicates an increased risk for developing CHD or of having an ischemic stroke and provide a healthcare practitioner with additional information about the tested person's overall risk.
A low or normal Lp-PLA2 means that this factor does not contribute to the tested person's risk of CVD.
The test is not diagnostic of CHD or ischemic stroke; it is a risk indicator. Many people with increased concentrations will not develop these conditions, and some with normal levels will.
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Is there anything else I should know?
While the findings from recent studies support the potential usefulness of Lp-PLA2 in CHD and ischemic stroke risk assessment, its ultimate clinical utility has yet to be established.
The Lp-PLA2 test is not widely available. In most cases, the blood sample will be sent to a reference laboratory and results will be available within a few days.
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Should everyone have an Lp-PLA2 test?
It is not currently indicated or recommended by major health organizations as a screen for the general population or recommended yet as a primary cardiac risk marker. Your healthcare provider can help you determine the best tests to determine your risk of developing CVD and provide you with information about changes you can make to lower your risk.
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How deadly are strokes?
According to the American Stroke Association, stroke is the fourth leading cause of death in the United States and a leading cause of disability. More than 80% of strokes are ischemic.