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The Vertical Auto Profile

By April 20, 2015Blog

Last week I introduced the concept that the present lipid panel is outdated and that the vertical auto profile (VAP) test is much more specific and a better estimate of a person’s cardiovascular risk. This week I will present a couple cases to illustrate how the VAP test can help.

  • This process spins the blood in an ultracentrifuge and divides the different subclasses of lipoproteins by weight.
  • It then directly measures the amount of each type of lipoprotein in the sample.

 

Case #1:

55y/o female with strong family history for heart disease:

Regular Lipid Panel:

LDL=90

HDL=60

Triglycerides=100

Total Cholesterol=185

One would think this woman has no increased risk for heart disease; but with the VAP test:

Lp(a)=80 mg/dL

(Lp(a) cholesterol= an inherited risk factor for atherosclerosis. Also called the “widow maker”)

Goal or Desirable Level < 10 mg/dL

  • Knowing this allows a doctor to tailor treatment appropriately: Lp(a) does not respond well to statins.

Case #2:

  • 56y/o female whose lipids went UP after starting a diet and fitness program where she ate only 10% fat. (The typical AHA recommendation):

Cholesterol Panel:

Total Cholesterol=231———went up to 285

LDL=158—————————went up to 180

HDL=55—————————-went up to 63

Triglycerides=90——————went up to 210

In this case VAP Test Results:

  • IDL=114 (Goal<20)
  • IDL does not respond well to typical lipid lowering therapies of low fat diet, statin or niacin.
  • Continue fitness program

Based on the VAP test patient was referred to registered dietician to educate patient on how to restrict carbohydrates and increase her fats to 35% of total calories including mostly monounsaturated fats. One month later VAP test:

  • IDL=20
  • Triglycerides=90
  • Total LDL=86

As these example cases demonstrate the Vertical Auto Profile is a definitive measurement of a person’s cholesterol and better treatment decisions can be made to help optimize a patient’s risk of heart disease.

Atherotech is the lab that developed the VAP test. It is FDA approved, covered by most medical insurances including Medicare. I would strongly recommend that all physicians research further the evidence behind the Vertical Auto Profile.

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