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Cardiovascular

The Latest Advances in Detecting Cardiovascular Disease

At Pristine Wellness Center we do a very comprehensive evaluation of the cardiovascular system, including but not limited to Cardio IQ blood test through Quest Diagnostics, some genetic testing (limited genes through Quest Diagnostics or the whole exome sequencing through NAG (“New Amsterdam Genomics”) and the CT angio of the heart using AI which is called “Cleerly.”

Interpretation of all these tests requires special training and not all providers offer these labs. Dr. Izadi is a quadruple board certified medical doctor with extensive training and experience in this field and one of few providers offering these tests. 

Cardio IQ Testing

Cardio IQ Testing is an advanced cardiovascular risk assessment tool that goes beyond traditional cholesterol tests to provide a detailed analysis of a person’s lipid profile and other biomarkers associated with heart disease. It is particularly useful for identifying individuals at risk of cardiovascular events who may not be flagged by standard testing.

What is Cardio IQ Testing

  •   A comprehensive panel of blood tests that assess cholesterol, lipoproteins, inflammation markers, and genetic predisposition to cardiovascular disease (CVD).
  •   It focuses on understanding the quality and subtypes of lipids, such as particle size and number, rather than just the quantity of cholesterol.
  •   Used to tailor personalized treatment plans for patients at risk of heart disease.

Components of Cardio IQ Testing

1. Advanced Lipid Testing:

  •   LDL Particle Number (LDL-P): Measures the number of LDL particles, which is a more accurate risk marker than LDL cholesterol.
  •   Small Dense LDL (sdLDL): Assesses smaller, denser LDL particles that are more likely to penetrate arterial walls and cause plaque buildup.
  •   HDL Subclasses: Evaluates the quality and functionality of HDL cholesterol.

  2. Lipoprotein(a) [Lp(a)]:

  •   A purely genetic marker that increases the risk of atherosclerosis and heart attack.

  Apolipoproteins:

  •   Apolipoprotein B (ApoB): Measures the number of atherogenic particles (like LDL and VLDL).
  •   Apolipoprotein A1 (ApoA1): Assesses the primary protein in HDL.

  Inflammation Markers:

  •   High-Sensitivity C-Reactive Protein (hs-CRP): Indicates inflammation in the arteries, linked to cardiovascular risk.
  •   Lipoprotein-Associated Phospholipase A2 (Lp-PLA2): Measures vascular inflammation and plaque stability.

  Insulin Resistance and Metabolic Health:

  •   HOMA-IR (Homeostatic Model Assessment for Insulin Resistance): Evaluates insulin resistance, a key contributor to metabolic syndrome and CVD.

  Genetic and Metabolic Markers:

  •   Fibrinogen: Associated with clot formation.
  •   Homocysteine: High levels are linked to cardiovascular disease.

Why is Cardio IQ Testing Important?

  •   Early Detection: Identifies cardiovascular risk factors that may not be evident in traditional cholesterol tests.
  •   Personalized Risk Assessment: Provides a more precise picture of heart disease risk by evaluating lipid particle size, inflammation, and genetic markers.
  •   Guides Treatment: Helps healthcare providers develop tailored interventions, including lifestyle changes, medications, or advanced therapies.
  •   Monitors Progress: Tracks the effectiveness of treatments and interventions over time.

Who Should Consider Cardio IQ Testing?

  •   Individuals with a family history of heart disease or high cholesterol.
  •   Patients with borderline or unclear risk based on traditional cholesterol tests.
  •   Those with conditions that increase cardiovascular risk:
  •   Diabetes or prediabetes.
  •   Metabolic syndrome.
  •   High blood pressure.
  •   Obesity.
  •   Patients with a history of premature cardiovascular events.
  •   Anyone with elevated lipoprotein(a) or other genetic risk factors.

We recommend these tests in all patients over 50 years of age as well. 

How is the Test Performed?

  •   Laboratory Analysis: The blood is analyzed for the various biomarkers included in the Cardio IQ panel.
  •   Results: Typically available within a few days, provided to your healthcare provider for interpretation.

Advantages of Cardio IQ Testing

  •   Comprehensive: Goes beyond basic lipid panels to identify specific cardiovascular risks.
  •   Predictive Power: Detects risk factors even in individuals with “normal” cholesterol levels.
  •   Actionable Insights: Guides personalized treatment, including dietary changes, exercise, and medications.
  •   Improved Outcomes: Early detection and intervention can prevent cardiovascular events like heart attacks and strokes.

Limitations of Cardio IQ Testing

  •   Cost: Cardio IQ testing is more expensive than standard cholesterol tests and may not always be covered by insurance.
  •   Interpretation: Requires a skilled healthcare provider to understand and apply the results effectively.

Cost and Insurance

  •   Cost: Typically ranges from $200 to $3,000, depending on the panel’s complexity and the provider.
  •   Insurance: Coverage varies; check with your provider to determine if the test is covered for your risk profile.

Next Steps After Cardio IQ Testing

  •   Adjust Lifestyle: Diet, exercise, and stress management tailored to your risk factors.
  •   Start Medications: Such as statins, PCSK9 inhibitors, or anti-inflammatory drugs.
  •   Follow-Up Testing: Monitor changes over time to evaluate treatment effectiveness.

Where to Get Cardio IQ Testing

  • Quest Diagnostics

Cardio IQ testing provides a cutting-edge approach to understanding and managing cardiovascular risk, making it a valuable tool for those with personal or family histories of heart disease or unexplained cardiovascular symptoms.

Cleerly Test

The Cleerly Test is an advanced, AI-powered, non-invasive diagnostic tool designed to assess heart health by analyzing coronary artery disease (CAD) through coronary CT angiography (CCTA). It offers a detailed evaluation of a patient’s coronary plaque characteristics and overall heart health.

Here’s everything you need to know:

What is the Cleerly Test?

  •   The Cleerly test uses AI algorithms to analyze data from coronary CT angiography (CCTA) scans.
  •   It evaluates plaque buildup in the coronary arteries, identifying the type, size, and volume of plaques (soft, calcified, or fibrous).
  •   The goal is to provide a comprehensive assessment of the patient’s risk of heart attack or other cardiovascular events.

Key Features and Benefits

1. Detailed Plaque Analysis:

  •   Differentiates between types of plaque, such as soft (dangerous) and calcified.
  •   Quantifies plaque burden and measures arterial narrowing.

2. Risk Prediction:

  •   Offers insights into a patient’s risk of heart disease, even before symptoms appear.
  •   Helps identify patients at risk of “vulnerable plaque” that can lead to a heart attack.

3. Non-Invasive:

  •   Requires only a CCTA scan, avoiding invasive procedures like cardiac catheterization.

4. Personalized Recommendations:

  •   Provides actionable insights for doctors to guide personalized treatments (e.g., medications, lifestyle changes).

5. AI-Driven Accuracy:

  •   AI-powered analysis ensures consistent and precise results.

What the Test Measures

  •   Total plaque volume: The amount of plaque present in your coronary arteries.
  •   Lipid-rich plaque: Soft plaque that is more likely to rupture and cause heart attacks.
  •   Stenosis: The degree of narrowing in the arteries.
  •   Calcium score: Measures the calcified portion of the plaque to assess long-term risks.
  •   Overall arterial health: Provides a detailed map of the coronary arteries.

Who Should Consider the Cleerly Test?

  •   Individuals with risk factors for coronary artery disease (CAD):
  •   Family history of heart disease.
  •   High cholesterol, high blood pressure, or diabetes.
  •   Smoking or obesity.
  •   Sedentary lifestyle.
  •   Those with symptoms such as chest pain or shortness of breath.
  •   Patients in need of a clearer understanding of their heart health to prevent future cardiovascular events.

How It Works

1.  Coronary CT Angiography (CCTA):

  •   A high-resolution scan of the coronary arteries is performed.

2.  AI Analysis by Cleerly:

  •   The scan data is analyzed using AI to generate a report detailing plaque characteristics, artery narrowing, and overall risk.

 3.  Results and Recommendations:

  •   The results are reviewed by a doctor who interprets the findings and provides treatment recommendations.

Advantages

  •   Non-invasive and quick.
  •   Detects plaque at early stages, even before symptoms.
  •   Helps avoid unnecessary invasive procedures.
  •   Enables preventive care, reducing the risk of heart attacks.

Cost and Insurance

  •   Cost: The price varies based on the facility but typically ranges between $1,500–$3,000.
  •   Insurance: Some insurers may cover the CCTA portion, but Cleerly-specific AI analysis might be out-of-pocket. It’s best to check with your insurance.

Where to Get the Cleerly Test

  • special imaging centers, referral, and order by the provider.

Preparation for the Test

  •   Avoid caffeine and heavy meals before the CCTA scan.
  •   You may be given a beta-blocker to slow your heart rate for better imaging.
  •   Follow the instructions provided by the imaging center.

Follow-Up

After the test, your doctor will discuss the findings and recommend:

  •   Lifestyle changes (diet, exercise).
  •   Medications (e.g., statins, blood pressure medications).
  •   Further tests or treatments if needed.

The Cleerly test is an excellent tool for early detection and prevention of heart disease, especially for patients with risk factors or symptoms. It provides actionable insights to guide personalized treatment and improve long-term outcomes.

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