How many here have had the VAP test? - High Cholesterol Message Board

Wintergarden · 06-02-2005, 12:29 PM

Whatever they call it at your health care provider, I'm talking about the advanced cholesterol testing where they calculate particle sizes and types and measure ominous substances like ApoB and Lpa. On various websites they have nicknames for Lpa like "the widow maker" and "heart attack cholesterol". THAT'S a lovely thing for a patient to read!

Why did I have to go and ask for this test? Arrrgh, now I'm driving myself absolutely NUTS waiting for the results. I'm not at all sure my cholesterol warrants this testing (TC: 142, LDL: 91, HDL: 36, TG: 73......of course it's the HDL there that's the concern, especially since I'm a pre-menopausal woman, but I think it's a result of a very low fat vegan diet...and further aggravated by malnutrition due to a recent stomach ailment).

I went to a cardiologist because I was noticing more and more skipped heartbeats, and I expected to get a holter monitor and echocardiogram (did get the latter, which was normal) All my Dr. wants to talk about is CAD, and it seems like it's going to be one test after another (even though I have no risk factors, other than the low HDL). At the time, I thought to myself, well, if I'm going to go through all this testing (next up is stress echo, and who knows where we go from there), let's see if there's a reason for it, and I asked for the VAP, which I had recently read about.

(btw, she has not found anything abnormal yet...all this concern on her part is based on my symptoms, namely, indigestion that gets worse when I exercise)

Didn't realize I'd have to wait forever for the results *sigh*. If I'm lucky, they might be in by next Friday....maybe. With all this time to think, words like "small particle trait" and "pattern B" (is that the bad one?) keep swirling around my head. I feel like I'm waiting for the results of a biopsy or something. I guess my question is, is this test anywhere near as damning as I've built it up in my head to be? If it's bad, how bleak is the picture? Can these traits be reversed?

One thing the nurse said when she was doing the blood draw sticks in my head - she said "and this test never needs to be repeated" - so I left with the impression that whatever it revealed, you were stuck with that for life.
But that seems odd, because presumably they're going to treat whatever abnormalities they may find, such as elevated Lpa? How would they know if the treatment was working?

My other question is, if this test is so valuable, why don't they give it routinely? I had to ask for mine, and I don't know anyone else who's had one. If my doctor thought enough of my CAD risk to give me nitroglycerin pills (which alarmed me), why wouldn't she order a VAP test?

Sorry for rambling - I'm nervous and trying to make sense of all this. Thanks in advance for your input!

JacquelineL · 06-02-2005, 03:59 PM

She probably didn't order it for the same reason a lot of doctors give. There is not much you can do to improve it except get your LDL as low as possible. Yours looks to be in a good range. I had a VAP test and an Lp(a) of 14. The desirable level is under 10.

Wintergarden · 06-02-2005, 06:32 PM

Hi Jaqueline - you know I was just reading an article online (American Family Physician, 2004) that stated that Lp(a) in women has no predictive value, and even in men, it seemed uncertain (except for stroke risk in elderly men). Could it be that these tests are still fairly controversial?

In any event, assuming some or all of the information does correlate to increased or decreased risk, wouldn't this let the physician know which patients to treat agressively? Also, according to the website of the lab which did my test (which admittedly, is profit motivated), they claim the results allow the doctor to tailor drug therapy to the patient's specific lipid traits.

It isn't a terribly expensive test - just a little more than the regular lipid profile, except I'll be getting a bill for my VAP test (insurance won't cover it). I just don't understand why it's not routinely done.

I just really hope I haven't saddled myself with a lot of information that's just going to frighten and depress me that I can do very little about. At least maybe it will help me determine whether it's worth going on niacin, as my doctor advised, even with the horrible side effects.

Lenin · 06-03-2005, 08:31 AM

Wintergarden,
Your Lipid panel is REMARKABLY similar to mine. I guarantee you will find the VAP results UTTERLY FASCINATING...and it will have you on the search engine for days afterward

!
I haven't had mine done yet but perused a couple "samples." Indirectly though, I've had my Lp(a) run a couple times, (don't ASK how bad

) and I've had my HDL2 and HLD3 run...2 is very protective, 3 is not.

Wintergarten, did your insurance company balk?
I tried calling mine in advance but I got a maroon who said I needed the PROCEDURE NUMBER...I said, can you look it up? She said "Ask your doctor?"

When I mention it to my doctor he'll say: "Who knows, call your insurance company!"
KETCHA' 22

I found a Cigna site that said very specifically that THEY don't cover it...they aren't my insurer thank God. Cigna won;t even cover LP(a) for people with proven disease.

JacquelineL · 06-03-2005, 11:33 AM

Lenin, if you are planning to get a VAP test, have you called the VAP people? I remember trying to get the same information and that was just to request the test. They were very helpful and did give me a number. I have also been able to find diagnosis codes online. My doctor once made a mistake by not including a diagnosis code and Medicare charged me for the full cost. It was corrected with some trouble. Now I make sure the codes are correct.

By the way, Medicare does cover the VAP test if you are diagnosed with high cholesterol.