Cardio Check

The Cardio Check Profile is an advanced assessment of lipids and cardiometabolic analytes to help stratify disease risk. It combines conventional and functional laboratory biomarkers to provide clinically actionable insights. 

Lipoprotein particles play a key role in cholesterol homeostasis, plaque formation and the development of cardiovascular disease.  

In measuring several classes of lipoprotein particles, the Cardio Check Profile may provide additional insight into an individual’s risk of developing cardiovascular disease beyond what a simple lipid panel can identify, and offer actionable insights and individualized care options for managing and mitigating cardiovascular risk​​. 

This test cannot be ordered for patients younger than 2.

What Does the Cardio Check Profile by Genova Diagnostics Include?

The Cardio Check Profile by Genova Diagnostics includes various biomarkers, each chosen for its clinical relevance in assessing cardiovascular risk and overall health. Here is a list of biomarkers included in the panel along with their rationales:

The Cardio Check Profile by Genova Diagnostics includes a standard lipid panel with the following markers:

‍Total Cholesterol: total cholesterol levels are a fundamental marker for assessing cardiovascular risk. Elevated total cholesterol levels are associated with increased risk of atherosclerosis and coronary artery disease (CAD).  [7.]

HDL Cholesterol: high-density lipoprotein (HDL) cholesterol is often referred to as "good" cholesterol because it helps remove cholesterol from the bloodstream, reducing the risk of atherosclerosis and cardiovascular events.  [2.]

LDL Cholesterol: low-density lipoprotein (LDL) cholesterol is considered the primary target for cholesterol-lowering therapy because elevated LDL cholesterol levels are strongly associated with increased risk of atherosclerosis and CAD.  [2., 7.]

Triglycerides: triglycerides are fat particles in the blood that come from recent dietary intake of saturated fat, simple carbohydrates, and/or alcohol.  Elevated triglyceride levels may signal dysfunctional metabolic processes including insulin resistance, fatty liver, and they are associated with an increased risk of cardiovascular disease.  [10.]

In addition to a standard lipid panel, the Cardio Check Profile by Genova Diagnostics also includes the following biomarkers that may provide insights into cardiovascular risk assessment beyond traditional lipid panel measurements:

Lipoprotein(a): Elevated lipoprotein(a) levels are an independent risk factor for cardiovascular disease, particularly in individuals with a family history of premature heart disease.  It is important to note that Lp(a) levels are genetically determined and change little, if at all, in response to diet and lifestyle.  [15.]

‍Apolipoprotein B (ApoB): Apolipoprotein B is a structural component of atherogenic cholesterol particles including VLDL, IDL, LDL and Lp(a)  particles and is considered a more accurate predictor of cardiovascular risk compared to LDL cholesterol levels alone, particularly in the setting of insulin resistance and diabetes.  [1.]

‍Apolipoprotein A1 (apoA1): apoA1 is attached to the surface of HDL particles, and is associated with a cardioprotective effect.  Elevated apoA1 levels are associated with improved HDL functionality and reduced cardiovascular risk, while low levels are independently linked to increased risk of cardiovascular events. Monitoring apoA1 levels allows for better risk prediction and assessment of therapeutic efficacy in managing cardiovascular disease risk. [8.]

hs-CRP (High-Sensitivity C-Reactive Protein): elevated hs-CRP levels are indicative of systemic inflammation and are associated with increased risk of cardiovascular events, including myocardial infarction and stroke.  [4.]

Homocysteine: elevated homocysteine levels are associated with increased risk of cardiovascular disease, including atherosclerosis, stroke, and venous thromboembolism.  [14.]

Who should get a Cardio Check Profile by Genova Diagnostics?

The Cardio Check Profile by Genova Diagnostics is particularly beneficial for individuals who may have a higher risk of cardiovascular disease (CVD), even if traditional lipid panel results are within normal ranges. Specific groups of people who might benefit most from this test include:

Individuals with a family history of heart disease or stroke: Genetic factors can play a significant role in an individual's risk for developing cardiovascular diseases. Those with a family history of these conditions may have inherited risks not visible in traditional lipid tests.

Patients with existing heart disease or those who have had a heart attack or stroke: For these patients, the Cardio Check Profile by Genova Diagnostics can provide a deeper understanding of their lipid profile and help manage their condition more effectively.

‍Individuals with diabetes or pre-diabetes: Since diabetes significantly increases the risk of heart disease, understanding the detailed lipid profile can help in managing these risks more effectively.

People with metabolic syndrome: Metabolic syndrome is a cluster of conditions that increase the risk of heart disease, stroke, and type 2 diabetes. The Cardio Check Profile can offer insights into specific lipid abnormalities associated with this syndrome.

Patients with high-normal LDL cholesterol levels on traditional lipid panels: Even if LDL cholesterol levels seem within normal ranges, the Cardio Check Profile can uncover the presence of cholesterol particles that are more atherogenic and pose a greater risk for cardiovascular disease.

Individuals with normal cholesterol levels who have heart disease: Some individuals develop heart disease despite having normal cholesterol levels, a condition sometimes referred to as "normal cholesterol heart disease." The Cardio Check Profile can help identify underlying risks not apparent in a standard lipid panel.

Patients seeking a more comprehensive cardiovascular risk assessment: Those interested in a detailed understanding of their cardiovascular health, beyond what traditional cholesterol tests offer may choose the Cardio Check Profile for its comprehensive analysis.

Collection and Shipping

This is a serum test requiring a blood draw.  Click here for full collection and shipping instructions for the Cardio Check Profile.  

Resources for Practitioners

Genova Diagnostics Cardio Check Support Guide

References

[1.] Behbodikhah J, Ahmed S, Elyasi A, Kasselman LJ, De Leon J, Glass AD, Reiss AB. Apolipoprotein B and Cardiovascular Disease: Biomarker and Potential Therapeutic Target. Metabolites. 2021 Oct 8;11(10):690. doi: 10.3390/metabo11100690. PMID: 34677405; PMCID: PMC8540246.

[2.] Centers for Disease Control and Prevention. LDL & HDL: Good & Bad Cholesterol. Centers for Disease Control and Prevention. Published 2017. https://www.cdc.gov/cholesterol/ldl_hdl.htm 

[3.] Das P, Ingole N. Lipoproteins and Their Effects on the Cardiovascular System. Cureus. 2023 Nov 15;15(11):e48865. doi: 10.7759/cureus.48865. PMID: 38106760; PMCID: PMC10724412.

[4.] Fonseca FA, Izar MC. High-Sensitivity C-Reactive Protein and Cardiovascular Disease Across Countries and Ethnicities. Clinics (Sao Paulo). 2016 Apr;71(4):235-42. doi: 10.6061/clinics/2016(04)11. PMID: 27166776; PMCID: PMC4825196.

[5.] Ghodsi S, Meysamie A, Abbasi M, Ghalehtaki R, Esteghamati A, Malekzadeh MM, Asgari F, Gouya MM. Non-high-density lipoprotein fractions are strongly associated with the presence of metabolic syndrome independent of obesity and diabetes: a population-based study among Iranian adults. J Diabetes Metab Disord. 2017 Jun 7;16:25. doi: 10.1186/s40200-017-0306-6. PMID: 28596946; PMCID: PMC5463311.

[6.] He Y, Kothari V, Bornfeldt KE. High-Density Lipoprotein Function in Cardiovascular Disease and Diabetes Mellitus. Arterioscler Thromb Vasc Biol. 2018 Feb;38(2):e10-e16. doi: 10.1161/ATVBAHA.117.310222. PMID: 29367232; PMCID: PMC5804739.

[7.] Jung E, Kong SY, Ro YS, Ryu HH, Shin SD. Serum Cholesterol Levels and Risk of Cardiovascular Death: A Systematic Review and a Dose-Response Meta-Analysis of Prospective Cohort Studies. Int J Environ Res Public Health. 2022 Jul 6;19(14):8272. doi: 10.3390/ijerph19148272. PMID: 35886124; PMCID: PMC9316578. 

[8.] Karjalainen MK, Holmes MV, Wang Q, et al. Apolipoprotein A-I concentrations and risk of coronary artery disease: A Mendelian randomization study. Atherosclerosis. 2020;299:56-63. doi:https://doi.org/10.1016/j.atherosclerosis.2020.02.002

[9.] Kontush A. HDL particle number and size as predictors of cardiovascular disease. Front Pharmacol. 2015 Oct 5;6:218. doi: 10.3389/fphar.2015.00218. PMID: 26500551; PMCID: PMC4593254.

[10.] Miller M, Stone NJ, Ballantyne C, et al. Triglycerides and cardiovascular disease: a scientific statement from the American Heart Association. Circulation. 2011;123(20):2292-2333. doi:https://doi.org/10.1161/CIR.0b013e3182160726

[11.] Otvos JD, Mora S, Shalaurova I, Greenland P, Mackey RH, Goff DC Jr. Clinical implications of discordance between low-density lipoprotein cholesterol and particle number. J Clin Lipidol. 2011 Mar-Apr;5(2):105-13. doi: 10.1016/j.jacl.2011.02.001. PMID: 21392724; PMCID: PMC3070150.

[12.] Packard CJ. Remnants, LDL, and the Quantification of Lipoprotein-Associated Risk in Atherosclerotic Cardiovascular Disease. Curr Atheroscler Rep. 2022 Mar;24(3):133-142. doi: 10.1007/s11883-022-00994-z. Epub 2022 Feb 17. PMID: 35175548; PMCID: PMC8983627.

[13.] Qiao YN, Zou YL, Guo SD. Low-density lipoprotein particles in atherosclerosis. Front Physiol. 2022 Aug 30;13:931931. doi: 10.3389/fphys.2022.931931. PMID: 36111155; PMCID: PMC9468243.

[14.] Refsum H, Ueland PM, Nygård O, Vollset SE. Homocysteine and cardiovascular disease. Annu Rev Med. 1998;49:31-62. doi: 10.1146/annurev.med.49.1.31. PMID: 9509248.

[15.] Reyes-Soffer G, Ginsberg HN, Berglund L, et al. Lipoprotein(a): A Genetically Determined, Causal, and Prevalent Risk Factor for Atherosclerotic Cardiovascular Disease: A Scientific Statement From the American Heart Association. Arteriosclerosis, Thrombosis, and Vascular Biology. 2021;42(1). doi:https://doi.org/10.1161/atv.0000000000000147

[16.] Xun P, Wu Y, He Q, He K. Fasting insulin concentrations and incidence of hypertension, stroke, and coronary heart disease: a meta-analysis of prospective cohort studies. Am J Clin Nutr. 2013 Dec;98(6):1543-54. doi: 10.3945/ajcn.113.065565. Epub 2013 Oct 16. PMID: 24132974; PMCID: PMC3831539.

[17.] Yang J, Wang Y, Xi Z, Ma Y, Shao C, Wang W, Tang YD. Remnant-Like Particle Cholesterol and the Risk of Major Adverse Cardiovascular Events: A Systematic Review and Meta-Analysis. J Cardiovasc Dev Dis. 2022 Dec 11;9(12):452. doi: 10.3390/jcdd9120452. PMID: 36547449; PMCID: PMC9781984.