PLAC Test Lp-pla2 Concerns

[ScttH641]

Hi there!

I made a post a a short while back about my concerns around some abnormal test results.

I had a test known as the PLAC test which looks for an enzyme known as Lp-pla2, this enzyme is linked to inflammation in the artery walls and is a biomarker for cardiovascular risk.

When I did the test last October it was within the low risk range, however upon taking the test again recently in May, its now showing as elevated meaning high risk.

My fear is from what I've seen online, is that this can be a predictor of acute cardiovascular incidents such has heart attack or stroke, as it detects rupture prone (soft) plaque.

The NHS don't offer this test, so my GP won't comment on it, I have had an appoinment with a private cardiologist but when I brought this up, he didn't really put my mind at rest, and in his letter I recived this morning, theres no mention of it, despite it being my main concern.

I'm getting very anxious about this as it seems nobody, even the company who did the test for me, is giving me a clear answer on what this means for me in regards to overall risk. I'm honeslty spending everyday now in fear the worst could happen any moment.

I don't understand why such a test would be offered if there's seemingly nobody who can give you a straight answer on it.

[Captain_Birdseye]

It's not a routine test, in the UK anyway... I'm not sure how much stock I'd put into this result, especially as the cardiologist isn't concerned about it. These guys are specialists in heart health after all.

Your cholesterol readings were ever so slightly high, and you've made positive changes to your diet since you got them so you're doing the right things in that regard.

If you're willing to go private, a cardiologist may be willing to refer you for a CTCA scan, where they can check your arteries, but they're usually reluctant to do so as these tests come with their own risks - so they'd likely only do this if you were considered to be at risk.

[Hidden in reply to Captain_Birdseye]

Unfortunately it's not just about cholesterol levels, there are other factors involved as well such as the enzymes mentioned.

[ScttH641 in reply to Captain_Birdseye]

Hi there

I did get a variety of checks including ECG, Echo, Calcium score and CT angiogram which all came back clean.

Its only just last month my cholesterol and LP-PLA2 seem to have gone out of whack for some reason.

So it can be argued that I have actually seen my coronary arteries at least, It's just scared me based on what I've read online about elevated LP-PLA2 and stuff like that, then seemingly nobody can put it in to any context, which makes it worse as I feel really lost and confused with it all.

[Captain_Birdseye in reply to ScttH641]

If your arteries are clear (or nothing was highlighted during those scans,) then honestly I think you're grand just now in terms of cvd.

Our bodies are complex biological systems and sometimes fluctuations happen. There can also be variances during testing depending on the operator, reagents or equipment used. I work in biopharma and have seen discrepancies come up if there's been an operator under training or a different batch of solution was used during testing.

I'd put this one down to experience and continue with what your doing, in my opinion.

[ScttH641 in reply to Captain_Birdseye]

Yeah, I think to be honest I've spent a bit too much time reading up on things online, to the point I've become a bit obssessed with it. I just think it scared me because even though I know cholesterol can be harmful, there's so much about lowering it and you can speak to almost any doctor about it. Where as this so few even have heard of it, then the limited sources online point it out to be this crystal ball type test that predicts events so accuratley.

Thank your for your messages though, I appreciate you taking the time to reach out.

[Captain_Birdseye in reply to ScttH641]

When I got my diagnosis last year I did the same thing... spent all my sick leave reading up on heart inflammation and what not. According to Google I should either be completely healed or dead by now.

Anxiety is a powerful state... I just wish I could put it to good use.

Hope you're feeling a bit better soon

[Hidden]

Hi. I am not sure if this test is similar, linked or indeed the same as LP(a). I recently had an LP(a) test done at a lipid clinic and had quite an in depth chat with the doctor there but I have no idea if it would be relevant, however I had the same sort of experience. The test is not offered routinely as basically there is nothing they or you can really do about it, statins will not make any difference, and yes unfortunately it is a marker for raised risk depending on the levels. I have never heard of a test that can detect soft plaque but if the pla2 does so, then yes it makes you more susceptible to HA and stroke sadly. She made a point of saying that research into it is in it's infancy and drugs to lower it are a few years at least off, so all you can do is make sure your other risks are mitigated as much as possible including getting your LDL down. What made you have the test in the first place if you don't mind me asking?

[Hidden]

Forgot to mention, I previously looked at this study and just having a quick glance again it appears it is linked to high LP(a), might be worth a read for you. The lipidologist also stressed the importance of as much exercise as possible for those of us with these raised levels.

ncbi.nlm.nih.gov/pmc/articl....

[ScttH641 in reply to Hidden]

Hi there

No its different to LP(a), in that this is an enzyme tied to inflammation, where as LP(a) is related to cholesterol.

LP(a) is geneticly assigned to each of us at birth, it stays the same throughout life, if you have high amounts of it, your at a higher risk, as its belived to be more 'sticky' than other forms of cholesterol.

LP-PLA2 despite its similar name is an inflammatory marker seen in arteries.

My concern was more around it seems wherever you look theres a different answer for what a PLAC test shows exactly, some places literally advertise it as 'check your risk for sudden heart attack or stroke'.

I took the test as my Grandma passed away about 9 years ago from a HA very suddenly, and I've always suffered with anxiety and depression but around my 30th birthday last year I got this overwhelming fear of dying etc. I would get ocassionaly pains etc, and it was really to get some peace of mind... which sadly it's now done the opposite.

[Engineer46]

In seven months your PLAC test result has gone from Low Risk to High Risk. Since you have no symptoms, it would seem very unlikely that anything significant has changed in your cardiovascular system in such a short time and this probably explains why the NHS doesn't use this test.

It may be difficult to ignore family medical history, but you have good results on all the standard and reliable tests, so try not to get anxious over one rogue and clearly unreliable test result.

Best wishes,

Paul

[Matman]

Bit late to this Thread, so not sure if you're still interested / concerned about the topic. That said, briefly - purely as part of a 'self-devised' routine screen - I'm getting the same Lp-Plac2 Test in the near future. 'IF' my results are 'above range' - then - because Lp-Plac2 is an Inflammatory Marker and (supposedly) also a possible indicator of excessive arterial plaque - my follow-up plan will be:

1. Request Imaging , i.e. possibly MR Angiography and / or Carotid Artery Ultrasound plus Ankle Brachial Test (probably 'private', simply for 'speed'). This is would be to try to see (via Imaging) and Testing, if I truly have an arterial plaque issue that warrants increased vigilance and / or early Intervention.

2. If any Imaging I had, suggested more aggressive measures were warranted (e.g. possibly higher dose - or different - Statin, PCSK9 Meds, or some other Intervention) at that point I'd need to decide which approach to go with. Likewise, if the Lp-Plac2 Result led on to Imaging (which, in turn, suggested I had a 'problem') I'd also 'guess' that any advice received would likely include 'adopting' more rigorous lifestyle modifications (e.g., Less / Zero Booze, Diet Modifications, Physical Activity improvement measures etc.,).

As I've read that Lp-Plac2 might also flag issues related to diabetic retinopathy, another 'useful action' I'd evisage taking (if my Test Values are raised) would be to get an Insulin Challenge Test, and to ask my GP to assess my Metabolic Health Risks. (I'm actually due to get one of those opti-scans - which many opticians now offer and, I'm told, that those kind of 'eye scans' can - apparently - provide indications as to overall vascular health. (If my initial Test Values are high, I'll also schedule further Lp-Plac2 Tests to monitor how effective any measures I take were progressing (and to see if future Lp-Plac2 Test Results improved or got worse).

As I'm about to go off-grid for quite a while I won't be in a position to respond to any reply / comments, but hope the above is in someway useful.

[ScttH641 in reply to Matman]

Hi Matman

I've had a CT Angiogram, 2 days prior to getting the LP-PLA2 test, which was all clear.

I have subsequently retested LP-PLA2 since my intial scare with elevated cholesterol and my results are now all normal, and my LP-PLA2 is now well within range.

My last advanced heart disease screening showed everything is in the optimal ranges thanks to my lifestyle changes.

My LDL / ApoB are excellent - LDL 1.52 mmol/l - ApoB 0.67

My LP(a) is <10 so not even a factor

I've also had all the necessary tests regarding diabetes and blood sugar, as it runs in my family and they have all been good.

From my conversations with a number of cardiologists, they dont seem to put much stock into LP-PLA2, and it's not really part of any guidelines.

Thank you for your reply though, and best of luck with all your future tests and health!!