I’m trying to learn more about this diagnostic test. Had my annual physical this week, which went well, but included a discussion of another immediate family member recently diagnosed with heart disease (now up to three). I almost can’t pretend anymore that I’m not at risk genetically. My mom had a silent heart attack when she was about my age (but had been a smoker, and had a complete hysterectomy at 41 y/o); my oldest brother had a stent put in when he was a year younger than I am now (but has been OK since then, 15 years ago) and last month my middle brother had a massive, almost deadly heart attack at 69 years old (still in the hospital after four weeks). I’ve been on statins for years, but my doc (has a certification in lipidology) was willing to give me a drug vacation last spring. My cholesterol shot up to 320, despite being fairly active and eating well. So he put me back on one and now my numbers are great. I am also on high blood pressure medication, again despite being fairly active and eating well (blood pressure is great now). He says I’m doing everything right, but suggested I have this test done next time I have a blood draw at his office. He also encouraged me to start taking a baby aspirin every day. One of the things this test does is to provide a look at the presence of Lipoprotein(a), which is an inherited risk factor for heart disease. It is considered more dangerous than other forms of cholesterol and does not respond well to traditional statins (my current cholesterol has responded excellent to statins). I really, really like my doctor and he gives me a lot of time to discuss this stuff, and we did, but once I got home, I started thinking about it more… do I really want for certain that I have an inherited risk? I don’t know that it would change any treatment and I wonder if, as the years pass, I will worry more and more, waiting for the ‘inevitable’. Or maybe I find out I do not have the inherited risk, and my family history is due to bad health habits. He’s really in no rush to do this, so I have time, but I certainly am contemplating both sides of doing it/not doing it.
http://atherotech.com/healthcare-providers/vap-lipid-panel/ is a list from a provider of the VAP+ test of the things that it measures, in comparison to the more usual blood lipid testing.
@teriwtt , hugs to you. While my family doesn’t have inherited heart issues-ours is colon cancer- I understand your dilemma. I was genetically tested for the colon cancer gene which came out positive. I then had the kids tested, they were negative.
The decision to have this test completed was huge and not taken lightly. For you, if you knew for sure would it add more stress to you? Or would knowing allow you to be more aware and therefore you’d be able to stay on top of the newest tests, medicine, reading medical journals, get involved in trials, etc.?
I would ask the doctor if the results might change your treatment regimen. If not, I’m not sure what advantage it gives you.
@ucbalumnus - I had looked at the company’s website briefly yesterday. It’s actually the Lp(a) that is the inherited risk part of the test that would probably most benefit me. But I can also find other websites that are critical of using these tests.
@VeryHappy - I am pretty sure it won’t change my treatment regimen right now as I’m doing everything right (other than the daily baby aspirin that he has said I could add). That doesn’t mean that, as new treatments become available, he might not consider adding something else, or using other diagnostic tests if they are proven scientifically well-researched.
@ChuckleDoodle - I hadn’t thought about the ramifications of what testing would mean for my children. I do know that when D2 recently found a new primary doc, part of her checkup included cholesterol, and hers is elevated a bit. D1 is still find with cholesterol. I’ll have to give that some thought.
In my reading about the test, it seems to be a more viable option for people who don’t respond to statins, and for people who have elevated triglycerides. I respond well to statins and my triglycerides are great.
I had genetic testing done for breast cancer. Now, I don’t know about my H, but I do not carry the BRCA gene and was able to tell my kids that.
Your kids are old enough to benefit from knowing whether you are positive or not.
My D did lose in the gene pool and has severe PCOS. WIsh we could have known about that earlier. It would have saved a great deal of time figuring out what the heck was wrong with her.
Knowledge is power.
teriwtt - yes I had the test and yes I have the risk. Funny I just had a doctor appointment yesterday and he upped my statin and put me on niacin as my numbers are not coming down. It’s hard for me to explain but the test is totally different than regular cholesterol. He’s testing particles. My particles are supposed to be under 600 and they are double that. There’s really no heart disease in my family he just gave me the test on a whim and here I am. My grandmother did have two heart attacks in her early 60’s and my doctor said, “you are your grandmother.” She was also diabetic even though she wasn’t overweight. Naturally I have that risk as well.
If I had a regular cholesterol test you would say my numbers are great. I’ve never had a problem with triglycerides either. I don’t regret taking the test but it is hard to hear your doctor tell you that you are going to have a heart attack. However, I’d rather have him say that now then be laying in the hospital. I wasn’t even taking statins before he gave me the test and then he immediately put me on them.
I would think that, especially for women, it would be nice to know as women need to be much more aware of their bodies and the symptoms of heart attack. Women’s symptoms are so different than the guys classic symptoms.
@PhotoOp - interesting that your regular cholesterol tests are normal, but the VAP test indicates you are at a high risk. You’re right… it’s about testing particles. When my doc first suggested a different test, I thought he was going to suggest the one that measure inflammation, but nope. Are you also on a daily regimen of baby aspirin?
So one of the things I did ask him was, if you take this test, is it something you use as a measuring tool over time to determine if your risk is increasing or decreasing. He sort of nodded his head no, saying that once your Lp(a) is measured, there’s really nothing you can do to change that number, but you can work on changing other indicators.
@sax - Obviously things have changed over the years, but my mom (when she was alive - she eventually died of complications due to CHF) could tell you exactly when she had that heart attack. She had horrible back pain for several days, and her doctor just told her to take aspirin (I don’t know if Tylenol was available yet) and stay in bed for a few days. So of course she had heart damage. And adding to her problem was the fact that she developed RA in her 50s, too, and spent a lot of time on prednisone, which, long-term, can increase cardiac issues. But yea, I guess it was common place back in the 1970s for doctors to pretty much dismiss atypical symptoms in women that were probably symptoms of a heart attack. The only reason they eventually diagnosed it is because a couple of years later, she went to the hospital for an elective procedure, and when they did the pre-surgical physical with an EKG, the reading showed the heart attack.
Sorry about your poor mom. I can’t imagine her anger that no one picked up on that. But it won’t happen to you. My mom probably died of complications of too much radiation. That probably won’t happen to me. My Husbands mom had no idea that the itchy mole under her bra was melanoma. No one ever had her take her bra off for any procedure so they never saw it. My H had melanoma before his mom and we didn’t know until I saw pictures in a magazine in my obgyn’s office. Now all of his family know what to look for. Won’t happen to them. Won’t happen to my kids.
Pioneers …all of them. So now we have more knowledge on fighting our own stuff. You too. Your kids too.
Not that anyone’s doing the happy dance but at least we know more.
I’ve had advanced lipid testing. The one I had was a NMR. My particle count is over the very high risk category. But, my cholesterol levels are just borderline high. I had it twice as it was offered for free and I pretty much ignored the test results being athletic and thin. However, my brother, 2 years older than me, died 1 1/2 years ago from a sudden cardiac arrest while riding his bike. My brother was an athlete with impeccable eating habits. So, I took the tests seriously. I can’t tolerate statins due to muscle aching, but I take Niacin which seems to control my cholesterol just fine.
But, I’ve talked to a number of cardiologists about advanced lipid testing, and I couldn’t find a single one who supported advanced lipid testing (NMR or VAP). In your case teriwtt, I’m not sure the benefit as you are already controlling your risks. For now, I am continuing my Niacin (short acting, the flushing kind is the most useful) as I like it. It has helped my mood and sleep as well.