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.