🫀 Advanced Cardiac & Vascular Risk Panel

1. Methionine

• Fasting: ✅ Yes
• System: Liver, Vascular, Metabolism
• Role: An essential amino acid involved in methylation and precursor to homocysteine
• Elevated levels: May impair methylation → cardiovascular risk, fatty liver, oxidative stress
• Associated With: Atherosclerosis, liver dysfunction
• Test With: Homocysteine, Vitamin B6, B12, Folate

2. hs-CRP (High-sensitivity C-Reactive Protein)

• Fasting: ❌ No
• System: Immune / Vascular Inflammation
• Role: Measures low-level inflammation, especially in blood vessels
• Interpretation:
  • <1 mg/L = Low risk
  • 1–3 mg/L = Moderate risk
  • 3 mg/L = High risk of heart disease or stroke
• Associated With: Atherosclerosis, metabolic syndrome, autoimmune flares
• Test With: Lipid profile, Lp(a), IL-6 (in research), Fibrinogen

3. Lipoprotein (a) [Lp(a)]

• Fasting: ✅ Yes
• System: Cardiovascular
• Role: Genetically determined lipoprotein that resembles LDL but is more atherogenic
• High levels = Increased risk of heart attack, stroke, or aortic valve disease
• Unaffected by diet/exercise, often elevated in families with early cardiac events
• Test With: Apo A1/B, LDL, hs-CRP

4. Apolipoprotein A1 (Apo A1)

• Fasting: ✅ Yes
• System: Lipid Transport
• Role: Main protein in HDL cholesterol (good cholesterol)
• High levels = Protective
• Low Apo A1 = increased risk for atherosclerosis
• Used For: Advanced lipid risk profiling, better than just HDL alone
• Test With: Apo B, HDL, TC/HDL Ratio

5. Apolipoprotein B (Apo B)

• Fasting: ✅ Yes
• System: Lipid Transport
• Role: Found in all atherogenic particles – LDL, VLDL, IDL
• High Apo B = High atherosclerotic risk, even if LDL is normal
• Considered more predictive of CVD than LDL alone
• Test With: Apo A1, Lp(a), LDL, hs-CRP

6. Homocysteine

• Fasting: ✅ Yes (at least 8 hours)
• System: Cardiovascular, Nervous, Methylation Pathways
• Role: Amino acid formed when methionine breaks down
• High levels = Artery damage and increased clotting risk
• Elevated in: Vitamin B12, B6, folate deficiency; genetic MTHFR mutation
• Linked To: Heart attack, stroke, dementia, miscarriage
• Test With: Vitamin B12, Folate, Methionine

7. Apo B / Apo A1 Ratio

• Fasting: ✅ Yes
• System: Lipid balance
• Role: Ratio reflects bad (Apo B) vs good (Apo A1) lipoproteins
• Ideal Value:
  • Men: <0.9
  • Women: <0.8
• Higher ratios indicate higher heart attack risk
• Test With: Total Lipid Profile, hs-CRP

✅ Summary Table: Clinical Relevance

🔄 Ideal Combined Workup (Cardio-Metabolic Risk Panel):