Want to know the risk of heart attack? (update May 2017)

The LP-PLA2 test measures the enzyme associated with causing inflammation in the arterial walls. The higher this enzyme, the more risk there is to the fibrous cap covering atherosclerotic lesions from detaching and entering the blood stream where it could create a blockage in a narrowed area of the artery.

Below is link to a UK website where you can learn more:

tdlpathology.com/media/4932...

26 Replies

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  • can you get this test done on nhs?

  • Here in Canada, it is not covered by public health so it likely isn't covered in the UK either. The cost here is between $35 and $75 CAD. Well worth the cost for. Peace of mind.

  • Ahh, ok, thanks

  • I had a look at the link, 2 pages of information, sadly the units of measurements used here not UK units! For any one UK to understand the information it is necessary to have UK units of measurements! If I ask my GP for referral my GP may not understand the units.

  • The document is produced in the U.K. the unit of measure is something you may not recognize, but obviously the UK organization who published this is aware of and understands the unit of measure.

    Either way, the published ranges for low and high risk are understood.

  • The footnote of the link is a UK address, the question will be whether the NHS path lab provides this test. The units quoted in the link are irrelevant as the path lab return a result plus limits to your GP.

  • In medicine we all need some understanding on dosage and units. doctors have got this wrong many times. Foot note, did you look at the date of this document.? 20016?

  • Bala the units are irrelevant, if the doctor has a measurement and a scale to compare it against as long as both have the same units. Here is a link to the clinical trial on NHS choices nhs.uk/Conditions/Clinical-... I don't know at what stage the trial is, but reading the article might reveal this. I have read it further and it is a trial that is studying the effect of a pill on Lp-PLA2 so it might be a test that is available to your GP. I will ask on my next visit.

  • Quite a number of private companies offer that test - and it was useful to revisit the March thread on this test: healthunlocked.com/choleste...

    And the Radio 4 Inside Health discussion of the test: bbc.co.uk/programmes/b04xp4x7

    It seems to be a well-regarded test but the consensus seemed to be that other readily available risk calculators are decent at categorising people - who might then consider diet, exercise, lifestyle modifications etc. alongside whether or not they need medication. Altho' this test is interesting, it doesn't seem to change the risk calculation by much:

    "And it seems to be that it does help to distinguish probably by around about a 1% change in your overall risk calculation at the end of the day. So it might put your numbers up by either one or possibly slightly more than that, possibly a bit less than that, or not at all. So it doesn’t seem to result in a very big shift with your overall percentage calculation of what your risk is thought to be of a heart attack or a stroke over the next decade. So it’s not going to make a huge change, is that change in risk say from 13-14% really going to be big enough for you to make a step change in deciding that you’re going to take a statin tablet every day or do exercise every day? Are these small changes really going to be enough to change something? Should you be doing it anyway? How useful is it going to be? I don’t think we really know because we haven’t used these tests in real life as a preventative tool widely enough."

  • From what I have read over the years this is not new, even The Daily mail published an article back in 2005. Clinical trails also goes to 2005. May be in the event of a problem A&E have this test? As for NHS, GP, standard test I need to investigate.?

    As per the post above, the radio clip and text, test may be carried out in (1%) risk!

    A good discussion post for people to get to know other test compared to standard cholesterol and lipid tests..

  • There is more:

    Test results are given in nanograms per milliliter (ng/mL).

    The normal range for Lp-PLA2 is less than 200 ng/mL.

    If your results are higher, you may have inflammation in your arteries. When both your CRP and your Lp-PLA2 are higher, you may be at greater risk of having a stroke.

    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 coronary heart disease (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.

  • The unit of measure was changed last year by the lab who developed the test (Cleveland Heart Labs) so the information you're quoting is no longer available. The reference range in the link that I posted is the new measure.

  • I found that one of health screening group in UK can do this test if one has a higher risk (number) from tests, "Is there any medication?"

    I like to find this out before spending money.

  • Please read the question and answer in this link:

    texasheart.org/HIC/HeartDoc...

  • You need to find the cause, so doing you can provide a cure. You have quoted the very cause of high cholesterol which is trying to repair the damage to the blood vessel. We reach for the pill bottle too quickly without looking for the cause of the problem first. You are eating something that's causing this. Not much help I'm afraid, but I hope to get you to think. Tibbly

  • Dr Stephen Sinatra -

    johnappleton.co.nz/media/wy...

  • Thank you for that link - it was very informative.

  • "In selected patients, statin drugs can improve quality of life and may even save your life ... " and then basically throws FH sufferers under the statin bus.

    I'm surprised to see such a paper being quoted here but I guess the lack of comments from the usual opponents of statins may hint that no-one has good answers for FH yet.

  • Reversing heat attack!

    The heart cannot pump blood effectively and some blood backs up into the body (lungs, legs, feet). This is called congestive heart failure.

    Having a heart attack means that you have lost blood flow to a part of the heart, and this has caused some heart muscle to die.

    Just making moderate changes in your diet may be enough to prevent heart disease, but it won't be enough to reverse it.

    One example is the research done in medical schools in the United States showing that congestive heart failure can be reversed with something as simple as repairing a copper deficiency. Not only that, but the heart muscle was literally regenerated

  • That seem wrong. The 1990 EXCEL study wasn't the first - I think that was the 1970s Japanese study of mevastatin. The US FDA even approved lovastatin in 1987.

    That video is also confusing correlation and causation. Just because two things are linked doesn't necessarily mean that one causes the other - they might be linked by some other factor.

    I feel that the arguments for being wary of statins are strong enough without basically lying like that.

  • Please read the information on this link:

    Clinical trails failed on medication for LP-PLA2.

    bcs.com/pages/news_full.asp...

  • I read it thank you.

  • As an interest to get a better understanding I did more research.

    Take control of your heart health 2 months ago by sos007:

    The PLAC test a.k.a. LP-PLA2 is a test that measures the amount of vulnerable plaque in your arteries that is subject to rupture. It is this unstable plaque in the arteries that causes heart attacks and stroke, not narrowed arteries (although they contribute to the process). Read the link below:

    lifeextension.com/Magazine/...

    I got this information from the link given in the post:

    Interpreting PLAC® Test Results

    Although the units measuring Lp-PLA2 levels are different from those used to measure total cholesterol, the ranges associated with different levels of risk are similar. Predictive Lp-PLA2 levels for acute cardiovascular events are:

    • Low risk: <200 ng/mL

    • Borderline risk: 200-235 ng/mL

    • High risk: >235 ng/mL.

    Levels over 200 or 220 ng/mL are very highly correlated with endothelial dysfunction, which in turn is highly correlated with cardiovascular events and predisposition to atherosclerosis. In practical terms, the PLAC® test can help physicians determine whether someone is at the high end of the low-risk group or at moderate risk. If they have a low Lp-PLA2, less aggressive management strategies may be indicated, while those with a higher level of Lp-PLA2 would more likely need intensive treatment.

    One response comment:

    I found the results of the PLAC test with bluecrest very easy reading.

    The readings were different to sos007 low risk < = 151 med risk 152 - 194 high risk > = 195.

    I wouldn't have thought statins made a difference to results but to be honest don't know. Good luck there is a lot of well researched information on this site.

    I rest my case.

  • Take your pick:

    UK testing:- low risk < = 151 med risk 152 - 194 high risk > = 195.

    Web link numbers:- • Low risk: <200 ng/mL

    • Borderline risk: 200-235 ng/mL

    • High risk: >235 ng/mL.

    I am trying to verify why? UK numbers are different, this may take some time!!!!

  • As noted in my previous message to you, the lab that originally developed the test, changed the unit of measurement in 2016.

    clevelandheartlab.com/wp-co...

    Don't get hung up on the unit of measure. That's like worrying about whether you measure the temperature in Celsius or Fahrenheit degrees. As long as you know water freezes at 0 and boils at 100 degrees on the Celsius scale, or 32 and 212 respectively on the Fahrenheit scale, that's what matters.

    As long as the lab doing the test provides a scale to assess risk, then which unit of measurement they use is irrelevant.

    Here is their current info sheet on this test and the reference range used to interpret results:

    clevelandheartlab.com/wp-co...

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