Regular cardiovascular disease (CVD) screening is vital to ensure that cardiac risk factors are detected in the earliest stages 1. Early CVD diagnosis aids in reducing the risk of a secondary cardiovascular event through ensuring early intervention and effective treatment plan implementation, thus aiding in the prevention of premature deaths. Early risk assessment is imperative in those with the greatest risk of CVD. This is evaluated through the identification of one or more risk factors including: hypertension, diabetes or hyperlipidaemia 2, 3. It is believed by 2030, almost 23.6 million people will die from CVD, mainly coronary heart disease (CHD) and cerebrovascular disease (CVA), and this is projected to remain the leading causes of death. This provides further confirmation that early diagnosis is vital to prevent and reduce the number of deaths attributed to CVD 3.
Randox offers an extensive range of 21 third party cardiac & lipid testing assays which includes superior performance and unique tests, which are internationally recognised as being of the highest quality; producing accurate and precise results.
Niche Tests
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Randox offers a range of niche tests including: Adiponectin, H-FABP and sdLDL-C. This means that Randox are one of the only manufacturers to offer these tests in an automated biochemistry format.
Superior Performance Tests
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Randox offers numerous cardiac & lipid testing assays that utilise a superior methodology, providing more accurate results. For example, the Randox Lp(a) test is one of the only methodologies on the market that detects the non-variable part of the Lp(a) molecule and therefore suffers from minimal size related bias.
Strong Correlation with Standard Methods
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The Randox cardiac & lipid testing assays display strong correlations when compared against standard methods, offering trust and confidence in results.
Wide Measuring Ranges
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The Randox cardiac & lipid testing assays can comfortably detect levels outside of the healthy range for the accurate detection of abnormal levels, offering peace of mind in patient samples.
Applications Available
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Applications are available detailing instrument-specific settings for the convenient use of the Randox cardiac & lipid testing assays on a wide range of clinical chemistry analysers.
The in vitro diagnostics market is continuously adapting to the changes in laboratory testing. Consequently, Randox have continued to reinvest in R&D to produce a variety of cardiac & lipid testing assays, including superior performance & unique tests, offering laboratories choice, quality and innovation.
The Randox Reagents range of cardiac & lipid testing assays encompasses superior performance & unique tests enabling laboratories to expand their routine test menus without expanding their labs. Not only does Randox Reagents provide confidence in patient results, the outstanding assay development in combination with superior performance methodologies contribute to the uncompromised quality offered by Randox Reagents. Moreover, laboratories can benefit from advanced assay testing with Randox Reagents.
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Adiponectin has been identified as having pleiotropic functions widely associated with anti-atherogenic, anti-diabetic, cardioprotective and anti-inflammatory effects. Adiponectin levels inversely correlate with insulin levels, BMI, triglyceride levels, insulin resistance (IR), glucose, and most importantly, visceral fat accumulation 4.
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A niche product from Randox, H-FABP is a highly sensitive and early risk marker of acute coronary syndrome, detectable as early as 30 minutes following the onset of an ischaemic episode. The implementation of a combined H-FABP high sensitivity troponin algorithm at an emergency department could aid in the identification of non-AMI patients on arrival, with the potential to reduce hospital admission by 36.8% 5.
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Hyperhomocysteinemia can cause inflammation of the endothelium. Failure to lower homocysteine levels can cause further inflammation of the arteries, veins, and capillaries causing atherosclerosis. Women with elevated levels of homocysteine have a 3-fold increased risk of CVD, whereas men have a 2-fold increased risk 6.
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A unique product from Randox, Lp(a) has proven to have a causal role in the pathogenesis of atherosclerotic and thrombotic vascular diseases 7. The Randox Lp(a) assay is one of the only methodologies on the market that detects the non-variable part of the Lp(a) molecule and therefore suffers minimal size related bias.
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A niche product from Randox, sdLDL-C, a subtype of LDL cholesterol, can more readily permeate the inner arterial wall. Research indicates that individuals with a predominance of sdLDL-C have a 3-fold increased risk of myocardial infarction 8.
Current Challenges
A combination of lifestyle factors can lead to a gradual build-up of fatty material (atheroma) in the arterial wall. The widespread accumulation of atheroma’s, otherwise known as atherosclerosis, can lead CHD. The disease develops gradually over many years, however as the symptoms are scarce, patients are unaware of the disease until chest pain onset. Pain and discomfort may arise if the arteries become so narrow that a limited amount of oxygenated blood can reach the heart (angina). If the problem persists and a piece of the atheroma breaks away a clot can form. If the clot blocks the coronary artery, the oxygen supply to the heart will be stopped resulting in myocardial infarction (heart attack). Continuous development of CHD causes the heart to weaken which can lead to heart failure 9.
Cerebrovascular disease includes a range of conditions that affect the flow of blood through the brain. This change in blood flow can lead to a temporary or permanent impairment of a patient’s brain function. The most common type of cerebrovascular disease is stroke. There are three main types of stroke; transient ischaemic attack, ischaemic stroke and haemorrhagic stroke, however an estimated 87% of strokes are ischaemic. An ischaemic stroke occurs when a blood clot prevents blood flow to the brain. An ischaemic stroke can be embolic, where the blood clot travels from another part of the body to the brain, or thrombotic, where the clot forms in the blood vessel in your brain 10.
PAD is a circulatory problem where narrowing of the arteries reduces the blood flow to the limbs. It can also be a sign of widespread accumulation of fatty deposits in the arteries, otherwise known as atherosclerosis. This could mean that there is reduced blood flow to the heart, brain and legs. The symptoms associated with PAD are mild or non-existent however in some cases patients can experience claudication symptoms. Claudication symptoms involve painful cramping in the hips, thighs or calf muscles triggered after completing certain activities such as walking. The location of pain depends on the position of the narrowed artery; however, the calf is most common. Other signs include leg numbness, a change in leg colour, shiny skin and weak pulse in the legs or feet. The pain of claudication can disappear after a few minutes rest, however, if the disease is left to progress the pain may occur when at rest and can become intense enough to disrupt sleep 11.
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References
[1] National Health Service (NHS). Cardiovascular disease. [Online] September 17, 2018. [Cited: November 30, 2018.] https://www.nhs.uk/conditions/cardiovascular-disease/.
[2] National Institute for Health and Care Excellence (NICE). Cardiovascular disease risk assessment and prevention. [Online] no date. [Cited: November 30, 2018.] https://bnf.nice.org.uk/treatment-summary/cardiovascular-disease-risk-assessment-and-prevention.html.
[3] World Health Organization (WHO). Cardiovascular diseases (CVDs). [Online] May 17, 2017. [Cited: November 30, 2018.] http://www.who.int/en/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds).
[4] New Insight into Adiponectin Role in Obesity and Obesity-Related Diseases. Nigro, Ersilia, et al. Napoli : BioMed Research International, 2014, Vol. 2014.
[5] Navarro CO, Kurth MJ, Lamont JV, Menown IB, Ruddock MW, Fitzgerald SP et al. Diagnostic Performance of a Combination Biomarker Algorithm for Rule-Out of Acute Myocardial Infarction at Time of Presentation to the Emergency Department, Using Heart-Type Fatty Acid-Binding Protein and High-Sensitivity Troponin T tests. Journal of Clinical & Experimental Cardiology 2018, Vol. 9
[6] Role of homocysteine in the development of cardiovascular disease. Ganguly, P and Alam, SF. 6, Riyadh, Kingdom : Nutrition Journal, 2015, Vol. 14.
[7] Lipoprotein(a). von Eckardstein, Arnold. 20, s.l. : European Heart Journal, 2017, Vol. 38.
[8] Austin. MA, et at, “Low-density lipoprotein subclass patterns and risk of MI”. JAMA 260, 1917, 1988
[9] Bupa. Coronary Heart Disease. Bupa. [Online] Bupa Health. [Cited: November 30, 2018.] https://www.bupa.co.uk/health-information/heart-blood-circulation/coronary-heart-disease.
[10] Nall, Rachel. What are the different types of stroke? Healthline. [Online] Healthline, May 24, 2018. [Cited: November 2018, 2018.] https://www.healthline.com/health/stroke-types.
[11] Mayo Clinic. Mayo Clinic.org. Peripheral artery disease (PAD). [Online] Mayo Clinic. [Cited: November 30, 2018.] https://www.mayoclinic.org/diseases-conditions/peripheral-artery-disease/symptoms-causes/syc-20350557.
