MD03 CardioIQ Report Annotation

Transcription

Cardio IQ®
Managing Residual Risk with
Advanced Cardiovascular Insights
The Cardio IQ® Report — Key Attributes
Test Results are
shown in “Optimal,”
“Moderate,” or “High”
risk categories and are
color-coded to display
progressive risk values.
Historic results
of previous tests are
provided with the
Cardio IQ report to
help monitor patient
progress.
Patient Information
Specimen Information
Age: 60
Fasting: Y
Patient Information
Age: 60
Test Name
Gender: M
Fasting: Y
Units
Test Name
Lipid Panel
Units
Collected 04/04/2014
Specimen
Cardio
IQ® Information
Client Information
High
Client Information
Gender:
M with RiskCollected
Result
Category04/04/2014
Result from
Optimal
Moderate
High
Result with Risk Category
Optimal
Moderate
High
High Ranges
Risk Category
12/18/13
Optimal Moderate
High
Result from
Risk Category Ranges
12/18/13
Optimal
EZ
Moderate Lab:
High
mg/dL
166
<200
200-239
mg/dL
mg/dL
mg/dL
mg/dL
mg/dL
mg/dL
mg/dL
mg/dL
61
166
81
61
89
81
2.7
89
105
2.7
55
105
>=40
<200
<150
>=40
<100
<150
<=3.5
<100
<130
<=3.5
<100
<130
N/A
200-239
150-199
N/A
100-129
150-199
3.6-5.0
100-129
130-159
3.6-5.0
100-129
130-159
Lipoprotein
Direct LDL Subfractions mg/dL
55
CHOLESTEROL, TOTAL
Lipid Panel
HDL CHOLESTEROL
CHOLESTEROL, TOTAL
TRIGLYCERIDES
HDL CHOLESTEROL
LDL-CHOLESTEROL
TRIGLYCERIDES
CHOL/HDLC RATIO
LDL-CHOLESTEROL
NON-HDL CHOLESTEROL
CHOL/HDLC RATIO
Direct LDL
NON-HDL CHOLESTEROL
mg/dL
mg/dL
LDL PARTICLE NUMBER
nmol/L
Lipoprotein Subfractions
LDL SMALL
nmol/L
LDL PARTICLE NUMBER
nmol/L
nmol/L
LDL MEDIUM
LDL SMALL
nmol/L
HDL LARGE
nmol/L
nmol/L
LDL MEDIUM
8500
Apolipoproteins
HDL LARGE
nmol/L
APOLIPOPROTEIN A1
Apolipoproteins
APOLIPOPROTEIN B
APOLIPOPROTEIN A1
APOLIPOPROTEIN B/A1
APOLIPOPROTEIN B
RATIO
mg/dL
APOLIPOPROTEIN
LIPOPROTEIN
(a) B/A1
RATIO
nmol/L
61
Infl
ammation(a)
LIPOPROTEIN
nmol/L
61
HS CRP
Inflammation
LP PLA2 (PLAC®)
HS CRP
FIBRINOGEN ANTIGEN
LP PLA2 (PLAC®)
Heart
Failure ANTIGEN
FIBRINOGEN
mg/L
ProBNP
Heart Failure
ST2, SOLUBLE
ProBNP
<100
100-129
Lab:
>129EZ
2000
<1260
1260-1538
300
2000
400
300
400
<162
<1260
<201
<162
>9386
<201
162-217
1260-1538
201-271
162-217
6996-9386
201-271
>1538
Lab: EZ
>217
>1538
>271
>217
<6996
>271
>9386
6996-9386
Lab:
EZ
<6996
77
>176
94-176
77
<52
>176
<0.29
<52
52-109
94-176
0.29-1.30
52-109
<94
Lab: EZ
>109
<94
>1.30
>109
<0.29
<75
0.29-1.30
75-159
>1.30
>=160
8500
80
mg/dL
mg/dL
1.04
80
mg/dL
1.04
<75
218
ng/mL
mg/L
mg/dL
ng/mL
218
4.5
<1.0
4.5
370H
<200
<1.0
<=350
<200
370H
mg/dL
503
pg/mL
ng/mL
pg/mL
503
>=240
Lab: EZ
<40
>=240
>=200
<40
>129
>=200
>5.0
>129
>159
>5.0
>129
>159
46
<=350
75-159
1.0-3.0
200-234
1.0-3.0
N/A
200-234
N/A
<=300
301-899
<=35
<=300
N/A
301-899
Lab: EZ
>=160
>3.0
Lab: EZ
>234
>3.0
>350
>234
Lab:
>350EZ
>=900
Lab: EZ
>35
>=900
4myheart
Diet & Exercise Coaching
weight? Managing
ST2, SOLUBLE
ng/mL Program: Need help achieving and
46 maintaining an optimal<=35
N/A stress?
>35
Trying to improve physical fitness levels? The 4myheart program provides support and personalized lifestyle guidance to
help
improve
heart
health. Coaching
Please talkProgram:
to your provider,
visit
4myheart.com
or call 1-800-432-7889
opt 2 Managing
to learn more.
4myheart
Diet
& Exercise
Need help
achieving
and maintaining
an optimal weight?
stress?
Trying toInformati
improveon
physical
fitness levels?
The 4myheart
program
provides
support
personalized
Medical
for Healthcare
Providers:
If you have
any questi
ons about
any and
of the
tests in our lifestyle
Cardio IQguidance
offering,to
help improve
heart health.opt
Please
talk toto
your
provider,
visitFor
4myheart.com
or call
1-800-432-7889
opt 2visit
to learn
please
call 1-800-432-7889
3 to speak
a clinical
liaison.
frequently asked
questi
ons, you can also
us at more.
htt
p://educati
on.QuestDiagnosti
cs.com/faq/FAQ134
Medical
Informati
on for Healthcare
Providers: If you have any questions about any of the tests in our Cardio IQ offering,
please call 1-800-432-7889 opt 3 to speak to a clinical liaison. For frequently asked questions, you can also visit us at
Metabolic
Markers
http://educati
on.QuestDiagnostics.com/faq/FAQ134
HOMOCYSTEINE,
Metabolic Markers
CARDIOVASCULAR
12.9
umol/L
<11.4
N/A
Lab: EZ
>=11.4
Lab: EZ
Note: This example represents the resulting report for an order of 92063, the Diabetes & ASCVD Risk Panel,
HOMOCYSTEINE,
umol/L
12.9
<11.4
N/A
>=11.4
% of
5.8
<=5.6
5.7-6.4
>=6.5
which includes lipid panel components,
ASCVD risk
scores, glucose and HbA1c value
and assessment
with
CARDIOVASCULAR
HEMOGLOBIN
A1c
total
diabetes risk scores.
Hgb
5.8
% of
HEMOGLOBIN
A1cTOTAL
total for 84
VITAMIN
25-OH,
ng/mL
This
reportD,format
is not available
patients under the age of 20 years.
<=5.6
>=30
5.7-6.4
20-29
>=6.5
<20
INSULIN
Hgb
uIU/mL
10
<23
N/A
>=23
INSULIN
uIU/mL
10
<23
N/A
>=23
>65-99
100-125
>=126
Lab: EZ
Reference
Ranges
customized
and age for each patient when possible,
based on
data from<20
VITAMIN D,
25-OH,are
TOTAL
ng/mL by gender
84
>=30
20-29
GLUCOSE
mg/dL
110
>65-99
100-125
>=126
published
literature. Reference
Range/Comments
reported separately at the end of
the report.
110
GLUCOSE
mg/dL
Omega
3 & 6 Fatty Acids, Plasma
2
For further information
about our Cardio IQ solution,
OMEGA 3 (EPA+DHA)
%
0.5 please visit Education.QuestDiagnostics.com
>3.3
1.1-3.3
<1.1
Omega 3 & 6 Fatty Acids, Plasma
Lab: EZ
INDEX
OMEGA 3 (EPA+DHA)
%
2.0
0.5
>3.3
>0.8
1.1-3.3
N/A
<1.1
<=0.8
1.04
APOLIPOPROTEIN B/A1
RATIO
LIPOPROTEIN (a)
nmol/L
61
<0.29
0.29-1.30
>1.30
<75
75-159
>=160
The Cardio IQ Report — Key Attributes
Inflammation
(Continued)
HS CRP
mg/L
LP PLA2 (PLAC®)
ng/mL
FIBRINOGEN ANTIGEN
mg/dL
®
Lab: EZ
4.5
218
370H
<1.0
1.0-3.0
>3.0
<200
200-234
>234
<=350
N/A
>350
Heart Failure
Lab: EZ
ProBNP
pg/mL
503
<=300
301-899
>=900
Pati
Information
Specimen Informati
on
Client Informati
ST2,ent
SOLUBLE
ng/mL
46
<=35 on N/A
>35
Age: 60
Fasting: Y
Gender: M
High
4myheart Diet & Exercise Coaching Program: Need help achieving and maintaining an optimal weight? Managing stress?
Trying to improve physical fitness levels? The
4myheart
program
provides support
personalized
guidance
Result
with Risk
Category
Resultand
from
Risklifestyle
Category
Rangesto
help Name
improve heart health. Please
Test
Units talk to your provider, visit 4myheart.com or call 1-800-432-7889 opt 2 to learn more.
Optimal If you
Moderate
High
Opti
Moderate
High
Medical Information for Healthcare Providers:
have any questi
ons about12/18/13
any of the tests
inmal
our Cardio
IQ offering,
Lipid
Panel on.QuestDiagnostics.com/faq/FAQ134
htt
p://educati
CHOLESTEROL, TOTAL
Metabolic Markers
HDL CHOLESTEROL
HOMOCYSTEINE,
TRIGLYCERIDES
CARDIOVASCULAR
LDL-CHOLESTEROL
HEMOGLOBIN
A1c
CHOL/HDLC
RATIO
NON-HDL CHOLESTEROL
VITAMIN D, 25-OH, TOTAL
Direct LDL
INSULIN
mg/dL
166
mg/dL
umol/L
mg/dL
61
mg/dL
% of
total
Hgb
mg/dL
ng/mL
mg/dL
uIU/mL
200-239
>=40
<11.4
<150
N/A
N/A
150-199
>=240
Lab: EZ
<40
>=11.4
>=200
2.7
<100
<=5.6
<=3.5
100-129
5.7-6.4
3.6-5.0
>129
>=6.5
>5.0
105
84
55
10
<130
>=30
<100
<23
130-159
20-29
100-129
N/A
>159
<20
>129
>=23
89
APOLIPOPROTEIN A1
2.0
5.8
APOLIPOPROTEIN B/A1
LPA ASPIRIN GENOTYPE
RATIO
nmol/L
mg/L
LP PLA2 (PLAC®)
rs1075728
FIBRINOGEN ANTIGEN
rs1333049
ng/mL
mg/dL
100-125
>=126
Lab: EZ
<1260
1260-1538
300
0.5
400
<162
>3.3
<201
162-217
1.1-3.3
201-271
>1538
Lab: EZ
>217
<1.1
>271
>9386
>0.8
6996-9386
N/A
>176
94-176
<94
52-109
Lab: EZ
>109
<6996
<=0.8
Lab: EZ
77
80
<52
lle/Met
Heterozygous
carrier: associated with elevated
Lp(a) levels
and CVD >1.30
risk
1.04
<0.29
0.29-1.30
and aspirin response in some clinical studies.
Trp/Arg
61
Heterozygous carrier: associated with increased
and greater >=160
CHD
<75CHD risk75-159
event reduction with atorvastatin and pravastatin therapy in certain clinical
studies.
Lab: EZ
Inflammation
HS
CRP
9p21
GENOTYPE
>65-99
2000
8500
mg/dL
Geneti
c Cardiovascular
Markers
APOLIPOPROTEIN
B
mg/dL
LIPOPROTEIN (a)
KIF6 GENOTYPE
12.9
110
GLUCOSE
Lipoprotein Subfractions mg/dL
LDL PARTICLE NUMBER
nmol/L
LDL SMALL
nmol/L
OMEGA 3 (EPA+DHA)
%
nmol/L
LDL
MEDIUM
INDEX
HDL LARGE
nmol/L
EPA/ARACHIDONIC ACID
RATIO
Apolipoproteins
Lab: EZ
<200
81
gg
Homozygous carrier (rs10757278 and rs1333049). Increased 9p21
4.5
<1.0
1.0-3.0
associated CVD risk.
218
<200
200-234
370H
cc
<=350
N/A
Advanced
cardiovascular tests
are organized into
functional categories
for ease of
interpretation:
• Lipid Panel
• Lipoprotein
Subfractionation
• Apolipoproteins
• Inflammation
>3.0
• Heart Failure
>234
• Metabolic Markers
>350
• G
enetic
Cardiovascular
Markers
APO E Failure
GENOTYPE
Heart
3/3
Apo E3 Carrier. Most common (normal) genotype.
ProBNP
LPA INTRON 25 GENOTYPE pg/mL
ST2, SOLUBLE
ng/mL
CYP2C19 GENOTYPE
cc
Homozygous
carrier: associated with elevated
Lp(a) levels
and increased
503
<=300
301-899
>=900
CVD risk.
46
<=35
N/A
>35
Intermediate metabolizer.
*2
Risk Ranges
indicate three levels
of risk based on
data from published
literature.
Lab: EZ
4myheart Diet & Exercise Coaching Program: NeedNoncarrier:
help achieving
and maintaining
an optimal
weight?
No increased
4q25 asssociated
risk
of atrialManaging
fibrillationstress?
or
4q25 AF RISK GENOTYPE
Trying to improve physical fitness levels? The 4myheart
program provides
cardioembolic
stroke. support and personalized lifestyle guidance to
help improve heart health. Please talk to your provider, visit 4myheart.com or call 1-800-432-7889 opt 2 to learn more.
rs2200733
cc
Medical Information for Healthcare Providers: If you have any questions about any of the tests in our Cardio IQ offering,
rs10033464
gg
http://education.QuestDiagnostics.com/faq/FAQ134
Metabolic Markers
HOMOCYSTEINE,
CARDIOVASCULAR
HEMOGLOBIN A1c
Lab: EZ
12.9
umol/L
5.8
% of
total
Hgb
ng/mL
84
INSULIN
uIU/mL
10
GLUCOSE
mg/dL
Test Name
Units
OMEGA 3 (EPA+DHA)
INDEX
Lipoprotein
Subfractions
LDL PATTERN
110
Optimal
High
0.5
%
Angstrom
Moderate
2.0
A
Result from
<11.4
N/A
>=11.4
<=5.6
5.7-6.4
>=6.5
>=30
20-29
<20
<23
N/A
>=23
>65-99
100-125
>=126
Optimal
Moderate
>3.3
1.1-3.3
>0.8
A
N/A
N/A
Lab: EZ
High
<1.1
Lab: EZ
<=0.8
B
3
The Cardio IQ® Report — Ion Mobility Detail
Metabolic Markers
HOMOCYSTEINE,
umol/L
HEMOGLOBIN A1c
% of
total
Hgb
12.9
Lab: EZ
<11.4
N/A
>=11.4
<=5.6
5.7-6.4
>=6.5
>=30
20-29
<20
<23
N/A
Lipid Subclass Distributions withCARDIOVASCULAR
related results are displayed graphically for ease of patient education.
5.8
ng/mL
84
INSULIN
uIU/mL
10
GLUCOSE
Patient Information
mg/dL
110
>65-99
100-125
Client Information
Age: 60
Fasting: Y
Gender: M
Patient
Omega 3Information
& 6 Fatty Acids, Plasma
Age:
60
Collected: 4/04/2014
OMEGA 3 (EPA+DHA)
%
0.5
Gender: M
Result from
INDEX
Test Name Y
Units
Fasting:
Opti
mal
2.0
EPA/ARACHIDONIC ACID
RATIO
Lipid Panel
The y-axis of the graph
shows total lipoprotein mass.
The x-axis of the graph
shows HDL and LDL
diameter in Angstroms (Å).
Shaded areas show key
clinical management metrics.
The height and width of the
area under the curve indicate
the amount of lipoprotein
particles contained within
each subclass.
HDL (High-Density Lipids)
The largest of the HDL
particles is a surrogate
marker for a functional
cardioprotective Reverse
Cholesterol Transport
mechanism. The goal of
treatment for CVD risk
reduction is to move from
a predominance of small
HDL particles to large
HDL particles.
LDL (Low-Density Lipids)
The smaller subclasses of the
LDL particles are associated
with increased inflammatory
potential, CVD risk, and rate
of atherogenic progression.
The goal of treatment for CVD
risk reduction is to move from
smaller to larger LDL particles.
Moderate
High
12/18/13
High
Client Information
166
61
lle/Met
81
TRIGLYCERIDES
LPA ASPIRIN GENOTYPE
mg/dL
LDL-CHOLESTEROL
mg/dL
89
Trp/Arg
2.7
NON-HDL CHOLESTEROL
mg/dL
105
Direct
LDL
9p21 GENOTYPE
mg/dL
55
CHOL/HDLC
RATIO
KIF6 GENOTYPE
rs1075728
gg
rs1333049
LDL PARTICLE NUMBER
APO
E GENOTYPE
LDL SMALL
nmol/L
cc
nmol/L
3/3
LDL INTRON
MEDIUM25 GENOTYPE nmol/L
LPA
HDL LARGE
nmol/L
CYP2C19 GENOTYPE
cc
Apolipoproteins
4q25
AF RISK GENOTYPE
APOLIPOPROTEIN A1
rs2200733
APOLIPOPROTEIN B
rs10033464
APOLIPOPROTEIN B/A1
RATIO
mg/dL
mg/dL
LIPOPROTEIN (a)
nmol/L
*2
cc
Opti
mal
>0.8
Moderate
N/A
<200
200-239
mg/L
LP PLA2 (PLAC®)
ng/mL
FIBRINOGEN ANTIGEN
mg/dL
High
<=0.8
Lab: EZ
>=240
Lab:
<40 EZ
>=40
N/A
Heterozygous carrier: associated with elevated
Lp(a) levels
and CVD>=200
risk
<150
150-199
and aspirin response in some clinical studies.
<100
100-129
>129
Heterozygous carrier: associated with increased CHD risk and greater CHD
<=3.5
3.6-5.0
>5.0
event reduction with atorvastatin and pravastatin therapy in certain clinical
studies.
<130
130-159
>159
Homozygous carrier (rs10757278 and rs1333049).
9p21
<100Increased
100-129
associated CVD risk.
>129
Lab: EZ
2000
<1260 1260-1538 >1538
Apo E3 Carrier. Most
300 common (normal) genotype.
<162
162-217
>217
Homozygous carrier:
associated
with
elevated
Lp(a)
levels
and
increased
400
<201
201-271
>271
CVD risk.
8500
>9386
6996-9386 <6996
Intermediate metabolizer.
Noncarrier: No increased 4q25 asssociated risk of atrial fibrillation orLab: EZ
cardioembolic stroke.
77
>176
94-176
<94
gg
80
<52
52-109
>109
1.04
<0.29
0.29-1.30
>1.30
<75
75-159
>=160
61
Inflammati
on TREATMENT GOAL
HDL
HS CRP
Lab: EZ
>3.3
1.1-3.3
<1.1
LIPID SUBCLASS DETAIL FROM ION MOBILITY
CHOLESTEROL, TOTAL
mg/dL
Geneti
c
Cardiovascular
Markers
HDL CHOLESTEROL
mg/dL
>=23
>=126
Lab: EZ
LDL TREATMENT GOAL
4.5
<1.0
1.0-3.0
<200
200-234
>234
370H
<=350
N/A
>350
218
Heart Failure
>3.0
Lab: EZ
ProBNP
pg/mL
503
<=300
301-899
>=900
Result
Category
ng/mLWith Risk
Result
with Risk Category46
ST2, SOLUBLE
<=35
N/A Ranges>35
Risk Category
Test Name
Units
Result from
Optimal
Moderate
High
OptiRanges
mal Moderate
High
Test
Name Diet & Exercise
Optimal
High
Result
from
Risk
4myheart
CoachingModerate
Program: Need help
achieving and
maintaining
an optimal
weight? Managing stress?Reference
(O) fitness levels?
(M)The 4myheart(H)
Trying to improve physical
program provides support and personalized lifestyle guidanceRange/Comments
to
help improveSubfracti
heart health.
Lipoprotein
ons Please talk to your provider, visit 4myheart.com or call 1-800-432-7889 opt 2 to learn more.Lab: EZ
Medical
Information for Healthcare
If you have any questions about any of the tests inAour CardioN/A
IQ offering, B
Angstrom Providers:
LDL
PATTERN
A
Angstrom
>222.5
218.2<218.2LAB: EZ
Lipoprotein
Subfractions
http://educati
on.QuestDiagnostics.com/faq/FAQ134 220.1
LDL
PEAK SIZE
222.5
LDL PATTERN
Metabolic Markers
A
O:A M:N/A H:B
A Pattern
Lab: EZ
HOMOCYSTEINE,
12.9 Risk of CVD events
<11.4is based
N/Aon a reanalysis
>=11.4
High
Tertile cut-points areumol/L
based on a reference range population.
LDL
PEAK SIZE
220.1
DIABETES RISK EVALUATION O:>222.5 M:218.2-222.5 H:<218.2 > OR = 218.2 Angstrom
CARDIOVASCULAR
(unpublished)
of the data presented in Musunuru et al. ATVB 2009;29:1975-80.
Glucose value and assessment
% of
NORMAL
VITAMIN
D, 25-OH, TOTAL
total
Hgb 110 mg/dL
5.8
PRE-DIABETES
ng/mL
84
DIABETES
INSULIN
uIU/mL
10
65
100
126
GLUCOSE
mg/dL risk for diabetes 110
Result consistent with increased
4
Lab:EZ
>=6.5
<=5.6
5.7-6.4
>=30
20-29
<20
<23
N/A
>65-99
100-125
>=23
>=225
>=126
¨
HEMOGLOBIN A1c
For further information about our Cardio IQ solution, please visit Education.QuestDiagnostics.com
Omega
& 6 Fatt
Acids, Plasma
HbA1c 3value
andyassessment
% 5.8% of total Hgb
¨
OMEGA 3 (EPA+DHA)
Lab: EZ
Lab:EZ
0.5
>3.3
1.1-3.3
<1.1
Lab:EZ
¨
NORMAL
110 mg/dL
PRE-DIABETES
DIABETES
The Cardio IQ Report — Other Detail
®
65
100
Result consistent with increased risk for diabetes
126
>=225
Metrics and information needed for comprehensive personalized reporting of cardiovascular risk.
HbA1c value and assessment
Lab:EZ
¨
5.8% of total Hgb
NORMAL
PRE-DIABETES
<=4.5
DIABETES
5.7
6.5
>=8.0
Patient Information
8 Year
Age:
60Diabetes Risk
Fasti(%)
ng: Y
Gender: M
Client Information
High
Lab:EZ
¨
6%
Test Name
<=3
Units
5
10
Optimal
15
Moderate
Result from
High
20
12/18/13
25
Optimal
Moderate
30
<200
200-239
>=240
>=40
N/A
<40
Lipid Panel
High
>=35
Lab: EZ
CHOLESTEROL, TOTAL
mg/dL
HDL CHOLESTEROL
mg/dL
166
OTHER DETAIL
61
81 Results
89
mg/dL
TRIGLYCERIDES
Test Name
LDL-CHOLESTEROL
mg/dL
Metabolic Markers (continued)
CHOL/HDLC RATIO
VITAMIN D,CHOLESTEROL
25-OH, D3
NON-HDL
mg/dL
105
mg/dL
55
VITAMIN
Direct
LDLD, 25-OH, D2
2.7
Results From
8
76
<150 Range/Comments
150-199
>=200
Reference
<100
100-129
>129
Lab: SLI
<=3.5
3.6-5.0
>5.0
ng/mL
<130
130-159
>159
<100 ng/mL
100-129
Lipoprotein
ons Plasma (continued)
Omega
3 & 6Subfracti
Fatty Acids,
>129
Lab:
Lab:EZ
EZ
LDL
PARTICLE
NUMBER
OMEGA
6/OMEGA
3 RATIO nmol/L
3.1
2000
<12601.3-12.0%
1260-1538
>1538
LDL SMALL
VITAMIN
D, 25-OH, D2
nmol/L
0.2
300
<162 0.3-2.3%
162-217
>217
LDL
EPA MEDIUM
nmol/L
2.2
DHALARGE
HDL
nmol/L
3.0
Apolipoproteins
mg/dL
Fish
APOLIPOPROTEIN B
mg/dL
Salmon
APOLIPOPROTEIN B/A1
Mackerel
RATIO
Sardines
LIPOPROTEIN (a)
nmol/L
Swordfish
400
8500
Foods High in Omega-3*
77
Oils
Nuts and Seeds
80
Walnut
Walnuts
1.04
Soybean
Flax seeds
APOLIPOPROTEIN A1
61
Flax
Pecans
Inflammation
Bluefish
Cod liver
Crab mg/L
Olive
LP PLA2 (PLAC®)
Cod ng/mL
Sardine 218
Lab: EZ
>176
94-176
Grains and Beans
<52
52-109
Soybeans
<0.29
0.29-1.30
Tofu
>109
>1.30
75-159
>=160
4.5
<1.0
1.0-3.0
>3.0
<200
200-234
>234
370H
<=350
N/A
>350
*Adapted from http://www.tufts.edu/med/nutrition-infection/hiv/health_omega3.html March 13, 2012
503
pg/mL
Result
ng/mL
<94
Lab: EZ
FIBRINOGEN ANTIGENScallops
mg/dL
Heart Failure
Personal Factors
ProBNP
Component
ST2,
SOLUBLE
>271
<6996
<75
Canola
HS CRP
<201 <2.3%
201-271
>9386 0.4-3.0%
6996-9386
Component
46
<=300
301-899
Result
<=35
N/A
Lab: EZ
>=900
>35
HEIGHT FEET
5 ft
SYSTOLIC BLOOD PRESSURE
140 mm Hg
HEIGHT INCHES
8 in
DIASTOLIC BLOOD PRESSURE 85 mm Hg
WEIGHT
155talk
lbsto your provider, visit 4myheart.com
TREATMENTor
FOR
B.P.
YES opt 2 to learn more.
help
improve heart health. Please
callHIGH
1-800-432-7889
Any test component
where clinical data do
not support the Optimal,
Moderate, or High cut
points as provided on
the Result with Risk
Category page will be
reported in the Other
Detail section of the
report.
A diet rich in Omega-3
fatty acids is associated
with a decreased risk of
cardiovascular events,
including sudden cardiac
death (SCD). These
common food items
provide a ready source
of Omega-3.
Patient information
supplied at the time
of order entry used in
the calculation of the
Diabetes & ASCVD Risk
Evaluation Scores.
CALCULATED
BMIon for Healthcare
24 Providers: If you have any questi
DIABETES
NOour Cardio IQ offering,
Medical
Informati
ons about any of the tests in
please
call
1-800-432-7889
opt
3
to
speak
to
a
clinical
liaison.
For
frequently
asked
questi
ons,
you
can also visit us at
AFRICAN AMERICAN
NO
PARENTAL HISTORY OF DIAB NO
CURRENT SMOKER
YES
Metabolic Markers
Lab: EZ
12.9
HOMOCYSTEINE,
umol/L
10-Year
ASCVD Risk Assessment (%)
CARDIOVASCULAR
5.7%
5.8
% of
total
Hgb
Low Risk
INSULIN
ng/mL
<=1%
uIU/mL
GLUCOSE
mg/dL
N/A
<=5.6
Your Risk:5.7-6.4
13.6%
%
>=6.5
Intermediate Risk Elevated Risk
>=30
20-29
<20
5%
7.5%
>=10%
<23
N/A
>=23
84
10
110
>65-99
100-125
Omega
3 & 6 Fatt
y Acids,
Plasma(%)
Lifeti
me ASCVD
Risk
Assessment
OMEGA 3 (EPA+DHA)
Your Risk
>=11.4
Lab:EZ
¨
Your Goal
HEMOGLOBIN A1c
<11.4
>=126
Lab: EZ
Lab:EZ
0.5
>3.3
1.1-3.3
<1.1
5
VITAMIN D, 25-OH, D2
Mackerel
EPA
0.2
Soybean
2.2
Flax3.0
Sardines
DHA
0.3-2.3%
Flax seeds
Tofu
<2.3%
Pecans
0.4-3.0%
The Cardio IQ® Report — ASCVD Risk Evaluation
A NEW expanded offering for insight into
Swordfish
Canola
Bluefish
Cod liverFoods High in Omega-3*
Crab
Olive
Fish
Cod
ASCVD
Salmon Risk
Scallops
Mackerel
is
Oils
Sardine
now
part of
Walnut
Soybean
Nuts and Seeds
Grains and Beans
the Cardio
WalnutsIQ Report.Soybeans
Flax seeds
Tofu
*Adapted from http://www.tufts.edu/med/nutrition-infection/hiv/health_omega3.html March 13, 2012
Sardines
Flax
Personal Factors
Swordfish
Canola
Pecans
Component
Bluefish Result
Cod liver
Crab
Olive
HEIGHT FEET
5 ft
Patient Information Cod
Sardine
HEIGHT INCHES
8 in
Age: 60
Fasting:
Y
Gender: M
Scallops
WEIGHT
155 lbs
Component
Result
140 mm Hg
Client Information
DIASTOLIC BLOOD PRESSURE 85 mm Hg
High
TREATMENT FOR HIGH B.P.
YES
on/hiv/health_omega3.htmlNO
March 13, 2012
CALCULATED BMI *Adapted from
24http://www.tufts.edu/med/nutrition-infecti
DIABETES
Result from
Personal
Factors
AFRICAN
PARENTAL HISTORY OF DIAB NO
Test
Name AMERICAN
Units NO
Optimal
Moderate
High
12/18/13
Optimal Moderate
High
Result
Component
CURRENT
SMOKER
YES
Component
Result
HEIGHT
Lipid
PanelFEET
140 mm Hg
Lab: EZ
DIASTOLIC BLOOD PRESSURE
Hg
<20085 mm200-239
AFRICAN
AMERICAN
5.7%
LDL-CHOLESTEROL
NO Risk89
mg/dLLow
PARENTAL HISTORY
OF DIAB
Intermediate
Risk
Risk
<100NOElevated
100-129
>129
CURRENTRATIO
SMOKER
CHOL/HDLC
YES
<=1%
mg/dL
105
<=3.57.5% 3.6-5.0
<130
130-159
>5.0
>=10%
>159
55
<100
NON-HDL CHOLESTEROL
Direct LDL
mg/dL
10-Year ASCVD Risk Assessment (%)
>=240
Lab:EZ
<40
TREATMENT FOR HIGH B.P. >=40YES
N/A
Your Risk: 13.6%
DIABETES
<150NO 150-199
>=200
¨
The Lipid Panel/
ASCVD Risk Panel
Assessment provides
the 10-year and lifetime
risk and 10-year goal
of atherosclerotic
cardiovascular disease
(ASCVD) using
lipid results with
anthropomorphic data
and family history.*†
5 ft
HEIGHT INCHES
CHOLESTEROL,
TOTAL
mg/dL8 in 166
10-Year ASCVD Risk Assessment (%)
WEIGHT
HDL
CHOLESTEROL
mg/dL155 lbs61
Your Goal
CALCULATED BMI
mg/dL24
81
TRIGLYCERIDES
2.7
5%
100-129
Lifetime ASCVD
Risk Assessment
(%)
Lipoprotein
Subfracti
ons
>129
Lab:EZ
Lab:EZ
Lab:
EZ
LDL MEDIUM
¨
Your ASCVD
Goal risk categories: > or =7.5% elevated risk; 5% to <7.5% intermediate risk; and <5% lower
Yourrisk.
Risk:
13.6%
10-year
Risk
estimates for
anLDL
ASCVD
(nonfatal MI,nmol/L
CHD death, or stroke) during the next 10
years are intended for patients
free of clinical
PARTICLE
NUMBER
2000
<1260 currently
1260-1538
>1538
Your
Riskevent
5.7%Risk was estimated using the
Low
Risk Cohort Equations: see Guidelines forIntermediate
Risk Elevated
Risk [Stone et al.
ASCVD;
Pooled
ethnic group-specific
considerations.
LDL
SMALL
nmol/L
300
<162
162-217
Not Calc:
10-year and/or lifetime risk/goal is not calculated because the required patient>217
Circulation
2013;
2013]
NOT CALC
%Goff et al. Circulation
<=1%
5% systolic blood<201
7.5% 201-271
>=10%
risk factors have not been provided (age,
pressure,
blood pressure
nmol/L
400 sex, race,
>271
medicati
use,
diabetes,
andpatient’s
smokerage,
status)
becauseand
a pati
ent value
notother
in the
range
This patient-specific 10-year ASCVD
risk on
goal
is based
on the
sex,or
ethnicity
optimal
levelsisfor
risk
factors.
HDLrisk
LARGE
nmol/L
8500total
>9386
6996-9386
This
goal is calculated using
the PooledbyCohort
Equations.
[Goff
et al. Circulation
2013]
accepted
the calculator:
cholesterol
(130-320
mg/dL), HDL
cholesterol
(20-100<6996
mg/
dL), systolic blood pressure (90-200 mm Hg), age (20-59 years, lifetime risk; 40-79 years,
10-year risk).
Apolipoproteins
Lab: EZ
Lifetime ASCVD Risk Assessment (%)
Lab:EZ
APOLIPOPROTEIN A1
mg/dL
77
>176
94-176
<94
Your Risk
APOLIPOPROTEIN B
mg/dL
80
<52
52-109
>109
Not Calc: 10-year and/or1.04
lifetime risk/goal is not calculated because
patient
NOT CALC % B/A1
APOLIPOPROTEIN
<0.29the required
0.29-1.30
>1.30
risk factors have not been provided (age, sex, race, systolic blood pressure, blood pressure
RATIO
medication use, diabetes, and smoker status) or because a patient value is not in the range
LIPOPROTEIN (a)
nmol/L
<75cholesterol
75-159
accepted by61the calculator: total cholesterol (130-320 mg/dL), HDL
(20-100>=160
mg/
dL), systolic blood pressure (90-200 mm Hg), age (20-59 years, lifetime risk; 40-79 years,
10-year risk).
Inflammation
Lab: EZ
HS CRP
mg/L
LP PLA2 (PLAC®)
ng/mL
4.5
218
<1.0
1.0-3.0
>3.0
<200
200-234
>234
FIBRINOGEN
370H
N/A
*The
ASCVD riskANTIGEN
assessment ismg/dL
recommended in the 2013 ACC/AHA Guidelines
on the Treatment<=350
of Blood Cholesterol
to >350
Reduce Atherosclerotic Cardiovascular Risk in Adults.1
Heart Failure
Lab: EZ
Risk calculations are provided at no additional cost and require the following personal factors at time of order entry: Age,
ProBNP
pg/mL
<=300
301-899
Gender,
Race, Systolic BP, Diastolic
BP, Treatment for High503
Blood Pressure, Diabetes, Parental history
of diabetes,
Smoker. >=900
†
ST2, SOLUBLE
46
ng/mL
<=35
N/A
>35
Metabolic Markers
HOMOCYSTEINE,
CARDIOVASCULAR
Lab: EZ
12.9
umol/L
<11.4
N/A
>=11.4
Reference
% of
5.8
<=5.6
5.7-6.4
>=6.5
1. Stone NJ, Robinson
J, Lichtenstein AH,
Bairey Merz CN, Blum CB, Eckel RH, Goldberg AC, Gordon D, Levy D, Lloyd-Jones DM, McBride P, Schwartz JS, Shero ST,
HEMOGLOBIN
A1c
total
Smith SC Jr, Watson K, Wilson PWF. 2013 ACC/AHA guidelines on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a
Hgb
report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2013. This article is co-published in the Journal of
the American
Cardiology. ng/mL
VITAMIN
D, College
25-OH,of TOTAL
84
>=30
20-29
<20
6
INSULIN
uIU/mL
GLUCOSE
mg/dL
10
110
<23
N/A
>=23
>65-99
100-125
>=126
For further information about our Cardio IQ solution, please visit Education.QuestDiagnostics.com
OMEGA 3 (EPA+DHA)
%
Lab: EZ
0.5
>3.3
1.1-3.3
<1.1
gg
rs10033464
The Cardio IQ® Report — Diabetic Risk Evaluation
Test Name
Patient Information
Units
Age: 60
Fasting: Y
LDL PATTERN
Test Name
LDL PEAK SIZE
Result from
Moderate
Optimal onModerate
High
SpecimenHigh
Information
Client Informati
Optimal
Gender: M
Angstrom
AResult with Risk Category
Angstrom
220.1
Moderate
Units
Optimal
High
High
Result from
12/18/13
Lab: EZ
ARisk Category
N/A Ranges B
>222.5
Opti
mal
218.2Moderate
222.5
Lipid Panel
<218.2
High
Lab: EZ
mg/dL
166
HDL CHOLESTEROL
mg/dL
mg/dL
TRIGLYCERIDES
61
CHOLESTEROL, TOTAL
<200
DIABETES RISK EVALUATION
NORMAL
CHOL/HDLC
RATIO
PRE-DIABETES
2.7
¨
LDL-CHOLESTEROL
81
110
mg/dL
mg/dL
89
DIABETES
NON-HDL
CHOLESTEROL mg/dL
105
65
100
Direct
LDL
mg/dL
55diabetes
Result consistent with increased risk for
126
200-239
>=240
>=40
N/A
<150
150-199
<40
Lab:EZ
>=200
<100
100-129
>129
<=3.5
3.6-5.0
>5.0
<130
130-159
<100
100-129
>159
>=225
>129
Lipoprotein
ons
HbA1c valueSubfracti
and assessment
LDL SMALL
NORMAL
Lab:
EZ
Lab:EZ
nmol/L
5.8% of total Hgb
nmol/L
PRE-DIABETES
2000
<1260
1260-1538
>1538
DIABETES300
<162
162-217
>217
<201
201-271
>9386
6996-9386
>271
>=8.0
<6996
¨
LDL PARTICLE NUMBER
nmol/L
LDL MEDIUM
<=4.5
5.7
6.5
HDL LARGE
nmol/L
8500
400
Apolipoproteins
8 Year Diabetes Risk (%)
APOLIPOPROTEIN A1
mg/dL
¨
6%B
APOLIPOPROTEIN
APOLIPOPROTEIN B/A1
RATIO
<=3
5 (a)
LIPOPROTEIN
77
mg/dL
10
nmol/L
61
>176
94-176
Lab: EZ
Lab:EZ
<94
80
<52
52-109
>109
1.04
<0.29
0.29-1.30
>1.30
15
20
25
<75
30 75-159
<1.0
1.0-3.0
>3.0
218
<200
200-234
>234
503
ng/mL
<=300
301-899
ng/mL
<=35
N/A
Inflammation
>=35
>=160
Lab: EZ
HS CRP
mg/L
LP PLA2 (PLAC®)
ng/mL
OTHER DETAIL 4.5
Test
Name are provided at no additional costResults
Results
From factors at Reference
Range/Comments
Risk
calculations
and require the following
personal
time of order
entry: Age,
FIBRINOGEN
ANTIGEN
mg/dL
N/A
>350
Gender,
Race, Systolic
BP, Diastolic
BP, Treatment for High Blood Pressure,370H
Diabetes, Parental history <=350
of diabetes, Smoker.
‡
The Metabolic
Markers used in
the Diabetes Risk
Evaluation are visually
presented to facilitate
patient education.
Metabolic Markers (continued)
Heart Failure
ProBNP
pg/mL
ST2, SOLUBLE
ng/mL
8
76
46
Lab: SLI
Lab: EZ
The risk estimate
is based upon the
assessment of adults
ages 30-79 in the
Framingham study.2
An estimate will not
be provided if HbA1c
and/or glucose indicate
that the patient has
diabetes. If fasting
conditions were not
met, use caution when
interpreting the glucose
test result and the risk
estimate.‡
>=900
>35
Omega 3 &
6 Fatt
y Acids,Coaching
Plasma (conti
nued)Need help achieving and maintaining an optimal weight? Managing stress?
Lab: EZ
4myheart
Diet
& Exercise
Program:
Trying
to
improve
physical
fi
tness
levels?
The
4myheart
program
provides
support
and
personalized
lifestyle
guidance
to
OMEGA 6/OMEGA 3 RATIO
3.1
1.3-12.0%
0.2
0.3-2.3%
EPA
2.2 liaison. For frequently asked questions, you can also
<2.3%
please call 1-800-432-7889 opt 3 to speak to a clinical
visit us at
DHA
3.0
0.4-3.0%
Metabolic Markers
HOMOCYSTEINE,
CARDIOVASCULAR
Foods High in Omega-3*
12.9
Oils
Nuts and Seeds
umol/L
Fish
Lab: EZ
<11.4
N/A
Grains and Beans
>=11.4
Reference
Salmon% of
Walnut 5.8
Walnuts
Soybeans
<=5.6
5.7-6.4
>=6.5
2. Wilson PW, Meigs JB, Sullivan L, Fox CS, Nathan DM, D’Agostino RB Sr. Prediction of incident diabetes mellitus in middle-aged adults: The Framingham
HEMOGLOBIN
A1c
total
Flax seeds
Tofu
Offspring Study. Arch InternMackerel
Med. 2007; 167:1068-74. Soybean
Hgb
Sardines
VITAMIN D, 25-OH, TOTAL ng/mL
Swordfish
INSULIN
uIU/mL
Bluefish
GLUCOSE
mg/dL
Crab
Cod Plasma
Omega 3 & 6 Fatty Acids,
OMEGA 3 (EPA+DHA) Scallops %
84
10
Flax
Pecans
Canola
Cod liver
Olive
110
>=30
20-29
<20
<23
N/A
>=23
>65-99
100-125
>=126
Sardine
Lab: EZ
0.5
>3.3
1.1-3.3
<1.1
7
The Cardio IQ® Solution Offers a
Comprehensive Approach to Heart Health
• Assess Baseline Risk by using advanced cardiovascular testing to help characterize a patient’s
individual cardiovascular disease risk.
• Guide Personalized Therapy by utilizing a patient’s unique makeup to help determine the therapy
they need to achieve better heart health.
−− Initiate/intensify statin therapy
−− Identify opportunities for adjunct therapy
−− Set diet, exercise and lifestyle targets
• Monitor Response to Therapy against a patient’s testing history to hone their treatment plan.
• Ongoing Patient Support through Clinical Educators helps patients understand
their test results and learn how they can adopt and adhere to their clinicians’ treatment plan.
• The 4myheart® Program is available at no additional cost for patients who have had testing
performed. The Quest Diagnostics Clinical Educators work with patients to set goals, focus on lifestyle
changes and develop treatment adherence strategies to help reduce overall cardiovascular risk. For
more information, visit 4myheart.com or call (800) 432-7889.
For more information, contact your Quest Diagnostics sales representative
or visit QuestDiagnostics.com/TestCenter
Notes for Advanced Cardiovasular Tests from Quest Diagnostics Aid (Order Code MI3985)
a. Being a carrier of this genetic risk factor does not mean that patient will develop AF or CE stroke. Similarly, patients who are noncarriers of this genetic risk factor are not immune to these heart disorders.
b. Being a carrier of this genetic risk factor does not mean that patient will develop early MI or AAA. The 9p21 genetic variant has been found to be associated with risk of AAA, but not rate of aneurysmal
expansion or risk of rupture.
c. The clinical impact of the CYP2C19 genotype on the metabolism of specific drugs will vary based on nongenetic factors, such as hepatic and renal status, other medications used (including over-the-counter
medications, herbals, and other supplements), alcohol or illegal drug use, race, age, weight, diet, and diseases present in an individual patient.
d. The benefit of statin therapy has only been observed with atorvastatin and pravastatin therapy. Other studies of simvastatin and rosuvastatin indicate that this benefit is not generalizable to all statins.
e. Aspirin therapy has only been studied with low-dose (100 mg) aspirin taken orally on alternate days.
f. Study populations predominantly consisted of caucasian men and women in Europe. LPA-Intron 25-associated risk has not been studied in African-American, Mexican-American, or East Asian populations.
However, carrier frequencies in these ethnic groups are approximately 2 percent in African-American and Mexican-American populations, and <1 percent in East Asian populations.
Clinical references supporting advanced cardiovascular testing may be found on the Test Descriptions and Clinical References pages of 4myheart.com.
Current supporting data for relevance of specific genetic tests may be limited to certain patient populations. Physicians should request and review the relevant product sheets before recommending a particular test as
part of a patient’s risk reduction plan.
The KIF6 Genotype Test, LPA Aspirin Genotype Test, LPA Intron 25 Genotype Test, 4q25 AF Risk Genotype Test, 9p21 Genotype Test, and CYP2C19 Genotype Test were developed and their performance
characteristics determined by Quest Diagnostics, a CLIA-certified and CAP-accredited laboratory. These tests have not been cleared or approved by the U.S. FDA.
QuestDiagnostics.com
Quest, Quest Diagnostics, any associated logos, and all associated Quest Diagnostics registered or unregistered trademarks are the property of Quest Diagnostics.
All third party marks – ® and ™ – are the property of their respective owners. ©2014 Quest Diagnostics Incorporated. All rights reserved. MD03 09/2014

MD03 CardioIQ Report Annotation

Transcription

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