Lipoprotein-associated phospholipase A2

Like you said, HSCRP, massive.

PLAC or the LPPLA2.

That's a mouthful of word salad.

Then you have, right? But I think hyperglycemia is one of the causes of cardiovascular disease.

And then Quest does another thing where it looks at the inflammation in your plaque.

If you Google the Cleveland Heart Labs report, they will give you a sample report and you can see where the chemicals that are tested in the Cleveland Heart Labs actually indicate where you're having problems, starting with rancid fats and rancid cholesterol that start the plaque formation, going on into high-sensitive C-reactive protein and ADMA that show vascular reactivity, and on into the higher level, really inflammatory plaque tests Myeloperoxidase, abbreviated MPO, and LP-PLA-2.

It's another lipoprotein that shows that your plaque is like a pus ball ready to explode.

These are really important tests that I rarely see the cardiologists looking at.

And then there's a couple other things that come with it.

Lipopro- Like, so there's LP, lipoprotein, PLA2.

It's carrying around a bunch of garbage.

You, you know, the more LP-PLA2 you got, the more garbage you got in your body.

Like you said, carrying it through your arteries.

Um, and then oxidized LDL.

OK, I've heard of that.

And there are also mice engineered to lack a specific inflammatory enzyme called PLA2G7.

Okay.

When the researchers checked these naturally long-lived mice, they found that they natively have much lower C3 cleavage in their visceral fat as they aged.

That means it's a relatively good reflection of inflammation somewhere in the body, so in the system.

a few more specific markers if it's just about blood vessels for example this LPPLA2 which you can measure is also very very specific or homocysteine when it comes to vascular inflammation you know there's a bit of other stuff It's also very super cheap.

You can also do it as part of a routine checkup.

But we are mainly concerned with this topic of inflammaging.

For example, when I see somebody that has bad arthritis, their CRP is always high, you know, despite a pretty negative cardiac workup.

So I like to get a myeloperoxidase level, an Lp-PLA2 level, um, and look and see how oxidized the LDL is, see which pathway is it going through, through your liver.

Is it going through an A pathway, which is a preferred LDL pathway, or the, the B pathway? If you have an A pathway, which is on the Cleveland, um, you know, your liver's able to, to get rid of the, the bad LDL particles more efficiently than if it was going through the B pathway.

So there's a lot of little things, you know, um, with a coronary, you know, CTA or just a plain coronary calcium scoring and not an angiogram, uh, that's minimal, that's reassuring.

And again, this is newer because we're really just getting to the high fatel- high fidelity CT angiograms, uh, that we can really actually now differentiate, um, you know, the, like the thickness of the fibrous cap, uh, that can help us to determine, you know, are plaques potentially stable or unstable.

There are some blood markers, uh, that, uh, are being looked at and investigated, uh, along these lines as well, things like LP-PLA2, uh, also known as the plaque test, PLAC test, uh, that, uh, is supposed to help differentiate between unstable and stable plaques.

Uh, and I've had, I don't know, I, I would say I'm mixed, uh, mixed Use of it in my practice, um, uh, because there are a number of these markers, myeloperoxidase being a number, uh, another one, and oftentimes you check this whole panel, uh, so ADA, ADMA, SDMA, uh, myeloperoxidase, LP-PLA2, and, you know, two of them are up and two of them are down, and you're like, "Okay, what do we do with this?" Uh, so, um, i-in terms of the CAC scan, um, you know, again, progression is important, and I do think any progression is a bad sign.

Now, um, even within progression, though, it gets more complicated.

And so, you know, I encourage people and, you know, if you're able to do this or get a good radiologist to do it for you, you actually want to look at the pictures because there's a difference in progression if you're, if that patient has developed new areas of calcification versus previous areas of calcification that have gotten denser calcium.

We need to talk about ways to work on your stress.

LP-PLA2 or lipoprotein PLA2, that's a marker that can tell you, without having to do additional tests, do you have unstable plaques in your arteries? This enzyme starts to get released when you have these unstable plaques.

And the higher the enzyme, the more you want to be cautious and maybe consider a test if that level is high, coronary artery calcium is high.

There's another test called an angiogram, which you have to get contrast for that.

There are blood tests we do that give us some feedback on how stable the plaque is.

Your test will tell me if it's soft, but if it's low density, friable, dangerous, then we look at lab markers that shed light to that, right? So you look at Lp-PLA2, F2-Isoprostane, even something as basic as CRP gives you some feedback as to how stable that plaque is, 'cause as we said earlier, even soft plaque can rupture, and that's what causes most problems.

So we're trying to make the plaque, number one, stable and smaller, and reduce inflammation.

So your test folds into what we do just perfectly.