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Test ID CVRMP Cardiovascular Risk Marker Panel, Serum

Useful For

Assessment for risk of developing cardiovascular disease, major adverse cardiovascular events, or ischemic cerebrovascular events

Profile Information

Test ID Reporting Name Available Separately Always Performed
NOHDL Non-HDL Cholesterol No Yes
CALDL Calculated LDL No Yes
HDCDC HDL Cholesterol, CDC, S Yes, (order HDCH) Yes
TCCDC Cholesterol, Total, CDC, S Yes, (order CHOL) Yes
TGCD1 Triglycerides, Total, CDC, S Yes, (order TRIG) Yes
CVINT Interpretation No Yes
LIPA Lipoprotein (a), S Yes Yes
HSCRP C-Reactive Protein, High Sens, S Yes Yes

Reporting Name

Cardiovascular Risk Marker Panel, S

Specimen Type

Serum


Specimen Required


Patient Preparation:

1. Patients must be fasting for at least 12 to 14 hours.

2. Patient must not consume any alcohol for 24 hours before the specimen is drawn.

Container/Tube: Serum gel

Specimen Volume: 2.5 mL


Specimen Minimum Volume

1.25 mL

Specimen Stability Information

Specimen Type Temperature Time
Serum Refrigerated (preferred) 7 days
  Frozen  30 days

Clinical Information

Cardiovascular disease is the number 1 cause of death in the United States with an estimated 1.5 million heart attacks and 0.5 million strokes occurring annually. Many of these events occur in individuals who have no prior symptoms. Standard risk factors, including age, smoking status, hypertension, diabetes, cholesterol, and HDL cholesterol, predict only about 65% of individuals who will go on to have a cardiovascular event. Therefore, identification of patients with residual risk is important to target lifestyle and pharmaceutical intervention to those at higher risk of future events.

 

Many additional risk markers have been identified for cardiovascular disease but few have emerged as independent risk markers. Two of these additional risk markers, high-sensitivity C-reactive protein (hsCRP) and lipoprotein (a) (Lp[a]), are clearly shown to be independently associated with increased risk of future cardiovascular events. Several recent guidelines have suggested that clinicians utilize hsCRP and Lp(a) in selected persons to augment risk classification, guide intensity of risk-reduction therapy and modulate clinical judgment when making therapeutic decision.(1-3) Prospective studies assessing these risk factors individually have determined them to be independently associated with increased risk for the development of ischemic events.

 

Guidelines recommend measurement of additional risk markers in individuals who are at intermediate risk for developing cardiovascular disease, those with early atherosclerosis without explanation by abnormalities of traditional risk factors, and those with a strong family history of cardiovascular disease without the presence of traditional risk factors.

Reference Values

Reference values apply to fasting specimens only.

 

Age

2-17 years

>18 years

Non-HDL Cholesterol (mg/dL)

**

Acceptable: <120

Borderline high: 120-144

High: ≥145

*

Desirable: <130 mg/dL

Above Desirable: 130-159 mg/dL

Borderline high: 160-189 mg/dL

High: 190-219 mg/dL

Very high: ≥220 mg/dL

LDL Cholesterol (mg/dL)

**

Acceptable: <110

Borderline high: 110-129

High: ≥130

***

Desirable: <100

Above Desirable: 100-129

Borderline high: 130-159

High: 160-189

Very high: ≥190

HDL Cholesterol (mg/dL)

**

Low: <40

Borderline low: 40-45

Acceptable: > 45

***

Males: ≥40

Females: ≥50

 

Total Cholesterol (mg/dL)

**

Acceptable: <170

Borderline high: 170-199

High: ≥200

*

Desirable: < 200

Borderline high: 200 - 239

High: ≥ 240

LIPOPROTEIN (a) (mg/dL)

≤30 mg/dL

Values >30 mg/dL may suggest increased risk of coronary heart disease.

≤30 mg/dL

Values >30 mg/dL may suggest increased risk of coronary heart disease.

C-REACTIVE PROTEIN HIGH SENSITIVITY

*

Lower risk: <2.0 mg/L

Higher risk: ≥2.0 mg/L

Acute inflammation: >10.0 mg/L

*

Lower risk: <2.0 mg/L

Higher risk: ≥2.0 mg/L

Acute inflammation: >10.0 mg/L

 

Age

2-9 years

10-17 years

>18 years

Triglycerides (mg/dL)

**

Acceptable: <75 

Borderline high: 75-99

High: ≥100

**

Acceptable: <90 

Borderline high: 90-129

High: ≥130

*

Normal: <150

Borderline high: 150-199

High: 200-499

Very high: ≥500

 

*National Lipid Association 2014

**Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents

***National Cholesterol Education Program (NCEP)

Interpretation

Specific interpretations are provided based on lipid results according to Mayo Clinic care process models. Mayo Clinic has adopted the National Lipid Association classifications, which are included as reference values on Mayo Clinic and Mayo Medical Laboratories reports (see Reference Values).

 

More aggressive treatment strategies may be pursued in patients determined to be at increased risk.

Clinical Reference

1. Jacobson TA, Ito MK, Maki KC, et al: National Lipid Association recommendations for patient-centered management of dyslipidemia: part 1 - executive summary. J Clin Lipidol 2014 Sep-Oct;8(5):473-488

2. Perk J, DeBacker G, Gohlke H, et al: European Guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J 2012;33:1635-1701

3. Goff DC, Lloyd-Jones DM, Gennett G, et al: 2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk. Circulation 2014;129:S49-S73

4. Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents; National Heart, Lung, and Blood Institute: Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents. Pediatrics 2011;128;S213-S256

5. Ridker PM, Rifai N, Rose L, et al: Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events. N Engl J Med 2002 Nov 14;347(20):1557-1565

6. Ridker PM, Danielson E, Fonseca FA, et al: Reduction in C-reactive protein and LDL cholesterol and cardiovascular event rates after initiation of rosuvastatin: a prospective study of the JUPITER trial. Lancet 2009;373:1175–1182

Day(s) and Time(s) Performed

Monday through Friday; Continuously

Analytic Time

Same day/1 day

CPT Code Information

80061-Lipid panel (includes: HDL [CPT Code 83718], total cholesterol [CPT Code 82465], and triglycerides [CPT Code 84478])

83695-Lipoprotein (a)

86141-C-reactive protein; high sensitivity (hsCRP)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
CVRMP Cardiovascular Risk Marker Panel, S In Process

 

Result ID Test Result Name Result LOINC Value
NOHDL Non-HDL Cholesterol 43396-1
CVINT Interpretation In Process
TCCDC Cholesterol, Total, CDC, S 2093-3
TGCD1 Triglycerides, Total, CDC, S 2571-8
HDCDC HDL Cholesterol, CDC, S 2085-9
HSCRP C-Reactive Protein, High Sens, S 30522-7
LIPA Lipoprotein (a), S 10835-7
CALDL Calculated LDL 13457-7

Method Name

LIPA, HSCRP: Automated Turbidimetric Immunoassay

TCCDC, TGCD1, HDCDC, NOHDL, CALDL: Selective Precipitation/Enzymatic Colorimetry/Friedewald Equation

Forms

If not ordering electronically, complete, print, and send a Cardiovascular Test Request Form (T724) with the specimen (http://www.mayomedicallaboratories.com/it-mmfiles/cardiovascular-request-form.pdf).