Heart Disease Tests Question: Which Blood Tests Are Needed When Assessing Heart Disease Risk?

My father died at age 45 from coronary thrombosis. My brother just died at age 59 of the same problem, and he had four stents. Are there any tests that can predict this?

Since coronary thrombosis runs in your family, I first recommend either the Vertical Auto Profile (VAP) test or the Lipoprotein Particle Profile (LPP) test. These newer cholesterol tests go beyond the standard (and woefully insufficient) blood lipid tests most doctors use to check cholesterol levels. They measure many different elements in your blood and determine if there are patterns in your blood fats that may lead to inflammation, which, in my opinion, is the core cause of heart disease. Learn more about these two cholesterol tests.

Also of critical importance, you need to have your blood tested for certain blood inflammation markers, which include elevated levels of:

• Homocysteine, a sulfur-containing amino acid that is highly toxic to blood vessels. It leads to endothelial dysfunction that results in accelerated aging, and it fuels inflammatory states that can cause atherosclerosis.
• Lipoprotein(a), or Lp(a), which is a highly inflammatory form of cholesterol that increases the stickiness of blood and can make developing a blood clot much more likely. Blood clots, of course, cause heart attacks and strokes.
• Fibrinogen, a protein that enables your platelets to clump together and helps determine the stickiness of your blood. You need adequate fibrinogen levels to stop bleeding when you’ve been cut, but higher-than-normal levels have been associated with too much blood clotting.
• C-reactive protein (CRP), a little-known marker of heart disease. When found in elevated levels, this blood protein may indicate heart attack and stroke risk.

In addition, I recommend having a fasting blood sugar test (an HbA1c test) and a fasting insulin test. The results will help to determine whether you are at risk for metabolic syndrome—a widespread precursor to diabetes and heart disease.

Finally, I would have some genetic testing done to check for the APO E4 allele. APO refers to a blood protein involved in fat metabolism, and alleles are combinations of genes. The presence of two alleles identified as E4 in these proteins suggests you may be susceptible to higher Lp(a) and triglyceride levels, lower HDL cholesterol levels, and a higher risk of heart disease.

Learn More From Dr. Sinatra

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