Some fascinating lipidology science was on parade at the recent American Heart Association Scientific Sessions 2012 in Los Angeles. There were plenty of promising advancements in cardiovascular disease and lipid research to report, but most exciting were the three groundbreaking subclass measurement presentations that featured the VAP Lipid Panel. These presentations highlighted that VAP lipid testing added value beyond what the basic lipid panel measured. It revealed hidden cardiovascular risks and the pivotal role that the VAP Lipid Panel played in multiple patient populations.

Just by reviewing the cases and conversations here on Cobble’s Corner, it’s apparent that CVD identification and management remains a significant challenge. Research informs us that 50 percent of men and 64 percent of women who die suddenly from CVD have no previous warning signs of disease.¹ Furthermore, 50 percent of people who experience a cardiovascular event have normal cholesterol² as measured by the basic lipid panel.

The VAP Lipid Panel, which provides clinicians accurate risk stratification through the identification of lipid subclasses, was included in the following abstract presentations at AHA 2012:

HDL Subclasses are Not All Created Equal:  Association of HDL Subclasses and Incident Cardiovascular Events in African Americans from the Jackson Heart Study (Abstract)
Author:  Parag Joshi, M.D., Clinical Cardiology Fellow, Johns Hopkins Hospital
Read my take on the study in this Medical Affairs Bulletin

HDL Cholesterol Subclasses and Mortality after Acute Myocardial Infarction:  The TRIUMPH Prospective Multi-Center Registry (Abstract)
Author:  Seth S. Martin, M.D., Cardiology Fellow, Johns Hopkins Hospital
Read my take on the study in this Medical Affairs Bulletin

Impact of LDL Pattern on Risk for CHD in the Framingham Offspring Population (Abstract)
Author:  Peter P. Toth, M.D., Ph.D. Director of Preventative Cardiology, CGH Medical Center
Read my take on the study in this Medical Affairs Bulletin

All three AHA presentations demonstrated the importance of the VAP Lipid Panel in clarifying the role of lipid subfractions in improved risk identification and management. Just as important VAP lipid testing showed value in diverse populations as listed above: African Americans, Post MI patients and the Framingham Offspring cohort. As the presentations demonstrate, and as scientific data continues to accumulate, it’s becoming increasingly evident that the VAP Lipid Panel:

• Provides information that points out multiple lipid defects, which adds value and goes beyond the limitations of the basic lipid panel for risk identification.
• Provides actionable results to employ an effective, personalized treatment strategy to improve outcomes.
• Is the gold standard for accurate subclass measurement.

Calculated values from basic lipid panels can miss up to 60 percent of those at risk for CVD. To uncover the underlying risk for CVD, much more needs to be examined besides a calculated VLDL and LDL values.

The AHA presentations highlight the increasing clinical value of subclass lipid measurements in multiple patient populations who are primary and secondary risk. The data regarding VAP Lipid information presented at AHA show that:

• VAP HDL₃ cholesterol levels were inversely associated with cardiovascular risk.
• VAP HDL₃ subclasses were associated with less risk for heart attacks in Jackson Heart study participants.
• VAP HDL₃ was predictive of significantly increased (50 percent) mortality risk, but overall HDL₂ was not in models adjusted for multiple covariates the TRIUMPH MI registry.
• VAP LDL B Pattern (the densest LDLc) is an independent risk factor for CHD, including acute myocardial infarction and sudden cardiac death in the Framingham Offspring Registry.

The AHA 2012 clinical trial presentations represent an increasingly powerful body of evidence that is being added to existing research that now includes outcomes data, such as the WellMed Study [link to CC post on this topic]), supporting the use of the VAP Lipid Panel as the gold standard for a comprehensive and accurate lipoprotein subfraction measurement.

Additional clinical trials involving the VAP Lipid Panel are currently underway and will be presented at future conferences and professional association meetings. We’re confident these trials will further demonstrate how the VAP Lipid Panel goes beyond traditional risk factors of the basic lipid panel to provide a more accurate picture of global CVD risk.