Every day, about 2,150 Americans die from heart disease, stroke and other forms of cardiovascular disease (CVD)–one every 40 seconds, according to “Heart Disease and Stroke Statistics–2015 Update: A Report from the American Heart Association.” CVD remains the leading cause of death in the United States, claiming more lives than all forms of cancer combined.
These are frightening statistics. Cleveland HeartLab (CHL) now offers our clinicians an analysis of their testing results, highlighting the impact that inflammatory testing is having on their patient population. This allows clinicians to understand the impact within their own practice of implementing a scientifically proven and peer-reviewed multi-marker approach. The analysis, which also includes relevant medical research findings and suggestions, is designed to:
- Help identify where your patient population is on a “spectrum of risk” by identifying those with risk of disease, presence of disease, and active disease that could result in a heart attack or stroke.
- Highlight the benefits of going beyond standard lipid testing to uncover “hidden” CV risk by examining specific, unique inflammatory biomarker combinations. A multi-marker approach identified up to 43 percent more at-risk patients than were found by checking LDL cholesterol alone in a recent study of more than 95,000 patients published in the peer-reviewed journal Future Cardiology.
- Examine complementary or additive testing options that may further improve management of your patient population.
Actionable Insights to Help Improve Patient Care
What can clinicians learn from a practice analysis? “The information Cleveland HeartLab provided gave us actionable insights that helped us improve our practice,” says Gina Pritchard, MSN, RN, CNS, ACNP, owner and cofounder of the Prevent Clinic in Plano, Texas.
“We were not surprised by the number of our patients who fell into the highest risk category–those with elevated Lp-PLA2 and MPO (Myeloperoxidase) results,” adds Pritchard. “But we value having the practice analysis data as a double check. The analysis was definitely eye-opening and prompted us to review our patient records and make sure we were following-up appropriately with our high-risk patients.”
Recent publications suggest that elevations in either of these biomarkers can signal increased near-term risk for a heart attack or stroke. Elevated Lp-PLA2 suggests active macrophages within the vessel wall that may contribute to vulnerable plaque formation, while elevated MPO is indicative of active white blood cells in the boodstream that may be responding to vulnerable plaque or erosions in the artery wall.
When both biomarkers are elevated, patients are at the greatest risk for heart attack and stroke, because they may have both active disease in the artery wall and a vulnerable collagen cap. “The charts and graphs in the analysis were of great value,” notes Pritchard. “It was exciting to look at our patients in more detail to help us manage them appropriately and keep them out of the cath lab.”
Inflammation Testing May Reveal “Hidden Risk”
The practice analysis for Prevent Clinic, which combined patient populations of 14 cardiovascular specialists (including Pritchard), also demonstrated how inflammatory testing can identify individuals with “hidden risk” for cardiovascular events.
There were 39 patients with “normal” levels of LDL cholesterol, yet 14 had elevated inflammatory biomarker elevations that may be attributable to atheroma burden and/or active vessel wall disease. “When you’re talking about heart attack and stroke prevention, you don’t want to miss anyone who is in danger,” says Pritchard.
For example, she recently evaluated a 35-year-old man who was seemingly in good health. His blood pressure and cholesterol were fine and he was always told he’d passed his annual physical. After a relative suffered sudden cardiac death while training for a marathon, the patient came to the Prevent Clinic for evaluation.
“Inflammation testing showed that this young father was actually at risk–and he was so thankful to get that information, which he felt was lifesaving, since he could get aggressive care to help prevent cardiovascular events,” reports Pritchard.
Cleveland HeartLab Tests Can Save $180 Million in Healthcare Costs
As Centers for Medicare & Medicaid (CMS) moves from volume-based to value-based care–also known as “pay for performance”–identifying “hidden risk” by adding cardiovascular inflammatory testing to standard cholesterol testing also has a significant potential to reduce healthcare costs.
A new peer-reviewed study model published in the Journal of Medical Economics, suggests that thousands of heart attacks and strokes could be avoided–and millions of dollars in healthcare costs saved–by using inflammation testing to improve cardiovascular disease (CVD) risk assessment. The study demonstrated that for a commercially insured U.S. health plan with one million members, implementing routine testing with CHL multi-tiered cardiovascular risk markers, specifically Myeloperoxidase, Lp-PLA2 and hsCRP, can decrease non-fatal MI events by 2,018 and non-fatal IS events by 1,848, resulting in $180.6 million in cost savings over five years.
For additional information on the Practice Analysis or have one completed for your practice please contact customer support at 866.358.9828, option 1.