LP-PLA2 Test

lp-pla2

What is LP-PLA2 test?

The LP-PLA2 test is a test which is carried out to assess the levels of Lipoprotein-Associated Phospholipase A2 in your blood. The results of this test convey the risk of you developing a cardiovascular ailment or stroke in the future

What is the role of Lipoprotein-Associated Phospholipase A2 in our body?

LP-PLA2 is an enzyme chiefly associated with low density lipoprotein (LDL). LP-PLA2 is carried to the walls of the coronary artery by LDL where it plays a role in the inflammation of the blood vessels. According to some studies, LP-PLA2 is an independent risk factor for cardiovascular disease.This enzyme is assumed to play an independent role in the development of atherosclerosis in the blood vessels.

Why has my physician asked me to undergo LP-PLA2 test?

Your physician may ask you to undergo LP-PLA2 test if-

– You suffer from a cardiovascular disease (CVD)

If you are at a moderate/intermediate risk for developing a CVD or an ischemic stroke (including, but not limited, to two or more of the following risk factors):

– Family history of CVD
– Male aged > 55 years
– Female aged > 45 years
– Diabetes mellitus
– Obesity
Hyperlipidemia
– Hypertension
– Physical inactivity
– Smoking
– Chronic renal ailment
Metabolic syndrome

Do I need to fast before the LP-PLA2 test?

Yes, you need to fast for at least 8-12 hours before undergoing LP-PLA2 test. Some physicians do not advocate fasting but most of the times, this test is performed in conjunction with other lipid-profile tests which need you to fast.

Can I undergo LP-PLA2 test if I am pregnant?

Yes, it is safe to undergo LP-PLA2 test if you are pregnant or breastfeeding your child. This is safe and easy to carry out test with no danger to the mother or her fetus.

How should I prepare for LP-PLA2 test?

No specific preparation is required. You need to discuss with the physician your medical history as well as family history. As LP-PLA2 test is a blood test, and involves the standard techniques of venipuncture, you need to inform your physician if-

– You are taking any blood thinners
– You are suffering from any coagulopathy
– You also need to give your physician in-depth information regarding the medicines (including ayurvedic, homeopathic, supplements, illicit drugs) that you might be consuming. Many medications including beta-blockers and steroids can alter the result of this test.

Are there any risks involved?

There are no serious complications of the LP-PLA2 test. It is a minimally invasive procedure. The risks, though rare, include-

– Bruising, or bleeding at the site from where blood is withdrawn has been reported.
– A hematoma may form at the site of venipuncture.
– Slight dizziness may be encountered when the vein is punctured or at the site of puncture.

It is advisable to look away during the procedure if you are faint-hearted. Infection at the site of venipuncture can be a late complication. Consult your physician if you observe any abscess or pus.

Is there any contraindication for the LP-PLA2 test?

There are no absolute contraindications to the LP-PLA2 test. However, if you are suffering from a coagulopathy or are on blood thinners, your physician may avoid making you undergo this test for the fear of a bleeding complication.

How is the LP-PLA2 test performed?

An LP-PLA2 test is performed as an outpatient procedure. It is a safe, minimally invasive and quick test. No sedation is given. The test can be carried out in a doctor’s office or at a diagnostic center. If you are already admitted to a hospital, this test will be carried out in a hospital setting itself. The test involves the following simple steps-

– You will be escorted to the collection site (an area in the lab/hospital for collecting specimens for testing).

– You will be asked to sit on a comfortable chair or lie down on a hospital bed.

– A technician will apply a tourniquet proximally to the site chosen for venipuncture. This makes the veins more prominent, allowing easier access.

– The area is cleaned with a disinfectant.

– A sterile needle is used to puncture the vein and draw blood.

– The pressure is applied to the vein with sterile gauze after the needle is withdrawn.

– The tourniquet is released.

– The blood sample is collected in a vial.

A small bandage is applied over the site from where blood has been drawn.

How long does the LP-PLA2 test take?

The process of LP-PLA2 testing does not take more than 5-10 minutes. However, in certain cases, venous access may be difficult to obtain; young children, obese patients and patients belonging to geriatric age group are a few examples. In these circumstances, more than 1 prick may be required while withdrawing venous blood for sampling, thus increasing the procedure time.

When can I get the results of my LP-PLA2 test?

You can get the results of the LP-PLA2 test within 48 hours, i.e., 2 working days.

What do the results of the LP-PLA2 test convey?

The normal range of LP-PLA2 in your blood is 200 nanograms per milliliter (ng/mL). A higher value indicates that you are an increased risk of CVD including coronary artery disease and stroke.

What is the cost of the LP-PLA2 test in India?

The cost of undergoing the LP-PLA2 test in India ranges from Rs 2500-5000 in India. The actual cost may vary depending on the city that you reside in and the healthcare provider that you choose.

What are the advantages and limitations of the LP-PLA2 test?

Advantages Limitations
LP-PLA2 is an independent marker for the risk of developing CVD. It involves venipuncture, so it cannot be used in individuals with coagulopathies.
It can be used to identify patients who have normal LDL but are at risk.It cannot be used as a screening test.
It can be used for risk assessment of patients who are found to be at borderline risk using traditional methods.It has no prognostic value.
It can be used to assess therapeutic efficacy. It is a costly test.

What other tests can be performed along with the LP-PLA2 test?

Your physician may also order other tests to calculate the levels of fats (lipids) in your blood. These tests are known as the lipid profile tests and include the quantitative measurement of-

Total cholesterol This test measures all the cholesterol that is present in your blood. It also includes HDL (the good cholesterol) and LDL (the bad cholesterol). An increase in total cholesterol may be due to an increase in either the good or the bad cholesterol. Therefore, a breakup of the individual components is important.

Apolipoprotein A this lipoprotein helps the HDL in protecting the heart. It aids in the clearing up of bad cholesterol from the blood.

HDL (high-density lipoprotein)– This is the good cholesterol as it protects the coronary arteries from getting clogged.

LDL (low-density lipoprotein)– This is the bad cholesterol and plays a primary role in clogging blood vessels.

Triglycerides– these are a type of fat.

VLDL (very low-density lipoprotein)– This is also considered to be bad cholesterol. Any increase in its levels carries a risk of CVD.

Total cholesterol to HDL ratio- This test is vital in assessing the risk of developing a CVD. Higher the ratio of Total cholesterol to HDL, higher is the risk

Another important biomarker that is commonly measured along with LP-PLA2 is C-reactive protein (CRP)- a major inflammatory biomarker. If the levels of both CRP and LP-PLA2 are high in your blood, your risk of developing a CVD increase manifold.

How can I reduce the levels of LP-PLA2 in my blood?

According to a recent report, cardiovascular diseases are now the leading cause of deaths in India. One in every four deaths (25%) in India is due to CVD with ischemic heart disease and stroke accounting for the bulk of the cases (80%).
Cardiovascular diseases are basically lifestyle ailments and adopting a healthy lifestyle can go a long way in ensuring that you keep these diseases at an arm’s length. The following steps, if taken can lead to a decrease in LP-PLA2 levels in your blood and thus decrease your risk of developing CVD-

– Quit smoking
– Take alcohol in moderation if you are in the habit of consuming alcohol
– Avoid fatty food
– Substitute refined rice with whole grains and legumes
– Add fresh fruits, vegetables, and nuts to your daily diet
– Avoid red meat. Instead, consume fish and chicken.
– Adopt an active lifestyle. Indulge in some outdoor physical activity
– Take prescription drugs if your physician prescribes them
– Go for regular dental check-ups; periodontal disease is a risk factor for cardiac ailments

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