New Protection from Coronary Heart Disease is
Avoiding Plaque Rupture with PLAC Test
FDA-approved blood test helps physicians determine
hidden risk for stroke or heart attack
Editor’s Note: Eighty-two percent of people
who die of coronary heart disease are senior citizens, but many are
still not aware that most heart attacks are not caused by plaque
buildup, but, rather, by plaque rupture causing blood clots that block
the blood flow. The following explanation of this danger and an early
warning test was prepared for SeniorJournal.com. by Dr. Paul Ziajka, Lipidologist
(more in sidebar).
May 20, 2009 - Heart disease is the leading cause
of death in the United States, with over 600,000 coronary heart disease
(CHD) deaths occurring annually, most of which occur among the senior
citizen population. According to the American Heart Association, 82% of
people who die of CHD are age 65 and older, and the average age of a
person having a first heart attack is 64.5 for men and 70.4 for women.
Stroke, another form of cardiovascular disease, is
the third leading cause of death in the United States and also prevalent
in the senior citizen population with one third of all strokes occurring
in people greater than 65 years of age.
Patients that survive a heart attack or stroke are
then at risk for another cardiac event. In fact, according to the
American Heart Association of the estimated 770,000 coronary events
forecasted this year nearly 60% of these patients will suffer a
recurrent event. With obesity at an all time high in the United States
it’s imperative that people educate themselves on their risks for life
threatening incidents.
Knowing your risk
Often times the first sign of a cardiac event is
the event itself, that’s why finding out one’s hidden risk is so
important. There are several factors that raise a person’s risk of a
heart attack and stroke, including high cholesterol, high blood
pressure, obesity, diabetes, smoking and physical inactivity. The more
risk factors a patient has the greater the risk of having a heart attack
or stroke.
Some risk factors are inherent and can not be
changed, such as increasing age, family history, and gender. Several
risk factors, however, can be addressed with lifestyle changes such as
exercise and diet, as well as medications.
Many mistakenly believe that heart attacks occur as
a result of clogged arteries or plaque buildup (stenosis). In fact,
approximately 68 percent of coronary events are caused by plaque
rupture and thrombosis (artery or vein blockage by blood clots).
Thrombosis occurs when unstable plaque enters the blood stream and
causes blood clots that block the coronary or carotid arteries resulting
in a heart attack or stroke.
While risk factor identification remains one of the
most important approaches to preventing cardiovascular disease,
traditional risk factors fail to identify many people at risk. In fact,
approximately 50 percent of all coronary events strike people with
low-to-moderate cholesterol levels, and about 20 percent occur in
individuals with none of the four major risk factors (high cholesterol,
high blood pressure, smoking, or diabetes). Therefore, hidden or
additional cardiovascular risk factors are likely to be common and there
is a critical need to identify all patients at-risk.
The PLAC Test
Fortunately, there is a simple new blood test that
goes beyond traditional risk factors to help identify patients at
increased risk of heart disease and stroke. The PLAC® Test is a simple
blood test that aids in detecting one’s risk for both CHD and ischemic
stroke.
The PLAC Test measures Lp-PLA2
(lipoprotein-associated phospholipase), a vascular-specific inflammatory
enzyme implicated in the formation of rupture-prone plaque. It is plaque
rupture and thrombosis, not stenosis, that cause the majority of cardiac
events.
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Author Dr. Paul Ziajka
 He
obtained his medical degree at the University of Miami, after
first earning both a Masters degree and a PhD in physics. He did
his internship in internal medicine at Orlando Regional Medical
Center, where he later served as chief of internal medicine.
In private
practice, his interest turned to lipid disorders and heart
disease. He has been an investigator in more than 50 clinical
trials involving heart disease, has been published numerous
times in peer-reviewed medical journals, has authored five books
on lipid management, sits on the editorial board of the Journal
of Clinical Lipidology and helped create the standards used for
board certification by the Board of Clinical Lipidology.
Dr. Ziajka
has traveled to forums all over the country lecturing thousands
of doctors about cholesterol disorders and treatment options.
He is a
fellow in the American College of Physicians, a member of the
Preventative Cardiology Nursing Association, a Clinical
Assistant Professor at Florida State University School of
Medicine, a Courtesy Clinical Assistant Professor in the
Department of Medicine at the University of Florida and an
Assistant Professor in the School of Nursing in the College of
Health and Public Affairs at the University of Central Florida.
Dr. Paul
Ziajka is a Lipidologist at the Florida Lipid Institute in
Winter Park, Fla. and can be reached at 407.671.8598.
Click here to visit Website. |
Used in conjunction with the clinical evaluation of
traditional risk factors, the PLAC Test helps identify people who may
not be identified by traditional risk factors and who may benefit from
more aggressive treatment programs.
Patients who have the PLAC Test are often shocked
to learn they have elevated Lp-PLA2.
Take, for example, Mr. Jones (not his real name,
see note below story) who was recently seen at the Florida Lipid
Institute. Mr. Jones is a 67-year-old gentleman with a history of
well-controlled hypertension.
He plays golf three to four times a week.
His cholesterol levels (on low dose statin medication) are within the
national guidelines and his overall risk based on his Framingham score
is “intermediate.”
One of his golfing buddies recently had a heart
attack that left him with severe congestive heart failure and an
inability to do anything more than sedentary activity. Mr. Jones’
question at the clinic visit was “is there anything else I can do to
lower my risk of a heart problem?”
The PLAC Test was drawn and came back at 420 ng/ml
(which translates into a 2-3 times increase in risk for a heart attack
or stroke compared to his Framingham risk). We agreed to be much more
aggressive in lowering his cholesterol, changed his medications and
three months later a repeat PLAC Test was at 120 ng/ml – well within the
“low risk” group.
Patients at increased risk for coronary heart
disease are candidates for aggressive treatment programs, such as
lifestyle modification, including an exercise program and a healthy
diet, and therapeutic intervention, including statin drugs and daily
aspirin.
It’s important to talk to you physician to
determine your risks. Patients interested in more information about the
PLAC Test can visit
www.plactest.com.
NOTE: Please note that as part of HIPPA
regulations this is not the real name of the patient, but his story is
both true and accurate. - Dr. Ziajka.
