The Complete Solution to Cardiac Risk Assessment

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The Complete Solution to Cardiac Risk Assessment

“CVDs are the number 1 cause of death globally: more people die annually from CVDs than from any other cause”.  In 2015, roughly 17.7 million people died from CVD, representing 31% of all global deaths: 7.4 million were due to coronary heart disease and 6.7 million were due to stroke. (WHO, 2017)

 

Cardiac health and regular cardiovascular screening is important to enable risk factors to be detected in their earliest stages.  There are a few factors which contribute to CVD.  These include: smoking, unhealthy diet, excessive alcohol consumption, low physical activity levels.  Whilst there are only a few factors contributing to CVD, these can be maintained by the patient through living a healthy lifestyle including: quitting smoking, consuming no more than the recommended allowance of alcohol, cutting out junk food, and exercising for 30 minutes a day, 3 – 5 days a week.  In a perfect world, this would be easy and CVD would not be a global problem.  However, due to busy lifestyles, cravings, reduced willpower, and convenience, not all individuals in today’s world will be able to avoid CVDs.  Therefore, it is vitally important that individuals are tested for CVDs to detect them in the earliest stages to reduce damage, prevent further damage, or even death.  Furthermore, many individuals suffer from inherited cardiac risk factors, which stresses the need for accurate testing of both traditional and novel cardiac risk biomarkers.

 

Randox offer the complete solution to cardiac risk assessment including: RX analysers, traditional and novel reagents, internal quality control (Acusera), and external quality control (RIQAS).

 

RX Series

Randox has developed the RX series range of clinical chemistry analysers for high-quality semi-automated and fully automated testing. Choose between the RX misano, RX monaco, RX daytona+, RX imola, and the RX modena depending on the throughput of your laboratory. The RX series offers a suitable analyser for your laboratory’s needs.  For more information on the Randox RX series, please click here or email therxseries@randox.com

 

Reagents

As previously mentioned, early assessment of cardiac risk is vital. Randox offer a range of novel risk biomarkers for both very early and the genetic assessment of cardiac risk.

The niche Adiponectin assay allows for the early assessment of CVD.  Adiponectin levels are inversely correlated with abdominal visceral fat which has proven to be a strong predictor of T2DM.  Body-Mass Index (BMI) is a common method for determining which patients are classified as underweight, healthy, overweight or obese, however, BMI does not take into account gender, ethnicity or activity levels.  For example, measuring the BMI of athletes who have a high BMI due to muscle weighing heavier than fat would classify them as obese which is inaccurate.  Measuring adiponectin levels is therefore a much more reliable indicator of at-risk patients compared to BMI.

LDL cholesterol is often referred to as the ‘bad cholesterol’.  High concentrations of LDL-cholesterol is considered to be the most important clinical predictor, of all single parameters, with respect to coronary atherosclerosis.  However, sLDL is a smaller, more dense subfraction of LDL-cholesterol.   sLDL particles more readily permeate the inner arterial wall and are more susceptible to oxidation.  Individuals with a predominance of sLDL have a 3-fold increased risk of myocardial infarction.  Measurement of sLDL allows the clinician to get a more comprehensive picture of lipid risk factors and tailor treatment accordingly.

Elevated levels of Lp(a) are considered to be both a casual risk factor and independent genetic marker of atherosclerotic disorders.  The major challenge associated with Lp(a) measurement is the size variation of apo(a) within Lp(a).  Dependent upon the size of apo(a) in the assay calibrator, many assays under or overestimate apo(a) size in the patient sample.  Numerous commercially available products suffer apo(a) size related bias, resulting in an over estimation of Lp(a) in samples with large apo(a)molecules and an under estimation in samples with small apo(a) molecules.  The antibody used in the Randox method detects the complete Lp(a) molecule providing accurate and consistent results.  This was proven by the IFCC who developed a gold standard ELISA reference assay and compared 22 commercially available tests.  The Randox Lp(a) method displayed the least (minimal) amount of apo(a) size related bias, proving it be a superior offering.

HDL3 Cholesterol is a smaller and more dense subfraction of the HDL particle.  HDL is the scavenger of cholesterol within arterial walls and the levels of HDL3 is too low, the ability to remove this cholesterol is reduced.  Therefore, it is widely accepted that there is an inverse correlation between HDL3 and CVD risk.

Instrument Specific Applications (ISA’s) are available for a wide range of biochemistry analysers.  Contact us to enquire about your specific analyser.

For more information on Randox Reagents, please click here or email reagents@randox.com

 

Acusera – Internal Quality Control

The Acusera cardiac controls have been designed to cover a wide range of cardiac markers at clinical decision levels, eliminating the extra expense of an additional low level control.  The controls are available in a both liquid ready-to-use and lyophilized formats making them ideal for all situations and manufactured from 100% human serum a matrix similar to that of the patient is guaranteed.  For more information on the Randox Acusera internal quality control, please click here or email acusera@randox.com

 

RIQAS – External Quality Control

The RIQAS Liquid Cardiac EQA programme is designed to monitor the performance of up to 9clinically significant cardiac markers including: CK-MB mass, D-dimer, Digoxin, homocysteine, hsCRP, myoglobin, NT proBNP, troponin I, and troponin T.  RIQAS is ISO/IEC 17043 accredited and allows the registration of up to five instruments at no extra cost.  All samples are 100% human serum and provided in a liquid ready-to-use format for enhanced convenience.  Submit your results bi-weekly and view reports online via RIQAS.Net.  For more information on RIQAS, the world’s largest international EQA scheme, please click here or email acusera@randox.com

 

For further information, please contact the Randox PR team via email: randoxpr@randox.com or phone 028 9442 2413

cardiac

 


Measuring T2DM Risk with Randox Automated Adiponectin

During the first week of our adiponectin educational month, we focused on different aspects of our free white paper “Early Risk Assessment of Type 2 Diabetes Mellitus Through the use of the Biomarker Adiponectin”, which details the features and benefits of Randox automated Adiponectin, clinical significance and a comparison to traditional methods for diabetes risk assessment.

Randox Adiponectin is an automated biochemistry reagent, used as a biomarker which can powerfully predict the development of pathologies such as Type 2 Diabetes Mellitus (T2DM) and cardiovascular disease (CVD). With the global prevalence of diabetes continually rising in adults over 18 years of age, from 4.7% in 1980 to 8.5% in 2014, adiponectin should be an integral part of every laboratory’s testing panel. Offering an improved method for assessing risk, with a convenient format for routine clinical use, Randox Adiponectin will enable physicians to accurately evaluate more individuals.

Read on to find out more!

Monday 11th September

Traditional Methods for Diabetes Risk Assessment

Randox adiponectin offers a more improved, automated method for assessing Type 2 Diabetes Mellitus (T2DM) risk compared to traditional methods of diabetes risk assessment. Such methods include:

  • Fasting Plasma Glucose (FPG) – This is the most commonly used biochemical method of assessing T2DM, however, the specificity of this test is poor. Although many individuals are identified as having impaired fasting glucose (IFG), their absolute risk of conversion to diabetes is only 5-10% per year.
  • Oral Glucose Tolerance Test (OGTT) – This method is more accurate for risk assessment than other traditional methods, however, it is rarely used in practice as it is takes two hours to perform and is uncomfortable for patients.

Non-biochemical methods for assessing a patient’s risk of developing T2DM take into consideration gender, age, family history of T2DM, BMI, waist size and high blood pressure to give a risk score. Two of the most popular, traditional indicators include:

  • Waist circumference – measures abdominal fat reliably, but its association with visceral fat varies by gender and ethnicity.
  • Body Mass Index (BMI) – is another common method, however it has limitations in measuring athletes and varies depending on age, sex and race.

Given the limitations of OGTT and FPG, an improved method for assessing T2DM risk, with a convenient format for routine clinical use, would enable physicians to accurately evaluate more individuals. Randox adiponectin is an automated biochemistry test utilising a latex enhanced immunoturbidimetric method which removes the inconvenience and time consumption associated with traditional methods of testing, making it a superior method of testing T2DM.

 

Tuesday 12th September

Clinical Significance

Recent studies have advocated the testing of adiponectin in clinical settings. It has applications in assessing risk in several diabetes-related conditions including prediabetes, T2DM and GDM. These studies include:

BMJ (2016): Adiponectin levels predict prediabetes risk: the Pathobiology of Prediabetes in A Biracial Cohort

This study found that among health white and black adults with parental history of T2DM, adiponectin level is a powerful risk marker of incident prediabetes. Thus, the association of adiponectin with diabetes risk is evident at a much earlier stage in pathogenesis, during transition from normoglycemia to prediabetes.

Diabetes Care (2013): Low Pre-pregnancy Adiponectin Concentrations Are Associated With a Marked Increase in Risk for Development of Gestational Diabetes mellitus

This was a study carried out on 4098 women who had children within 6 years of initial blood sample and none of whom were pre-diabetic or diabetic. It was found that lower adiponectin concentration measured on average 6 years before pregnancy were associated with a 5-fold increased risk of developing GDM.

 

Implications for Clinicians

Adiponectin measurement is not yet a routinely run test in many laboratories worldwide and it is therefore not available for many clinicians to request. Yet the implications of this becoming widely available could be extremely valuable as it can help to assess:

  • Type 2 Diabetes Mellitus and Incident prediabetes
  • Cardiovascular events
  • Gestational Diabetes

When risk is identified via adiponectin measurement, it is essential for individuals to carry out lifestyle modification to reduce visceral fat levels and lowering T2DM risk. This will also help to prevent the development of cardiovascular diseases and metabolic syndrome through the improvement of adiponectin production. This indicates that Randox automated adiponectin should be a routinely run test across the world.

13th September 2017

Methods of Measuring Adiponectin

Randox adiponectin automated method has many benefits for the laboratory, as the only method of adiponectin measurement available beforehand was through the ELISA assay. The benefits of switching from ELISA to an automated method include efficiencies and expansion.

Efficiencies

The main drawback of using ELISAs for clinical testing within a laboratory is that it is time consuming and personnel consuming as it uses heavy resources with manual interaction. Switching from ELISA to an automated method for the detection of adiponectin increases time and personnel efficiency considerably which leads to cost effectiveness. This benefits laboratories through:

  • Ensuring quality in testing practices and confidence in clinical results
  • Lowering the risk of error and contamination avoiding compromising clinical results

 

Expansion

Laboratories can expand their test offerings to patients and clinicians by transitioning analytes which were historically only available on ELISA methods. Adiponectin being available in an automated biochemistry format allows laboratories to expand their test menu with ease and enables the inclusion of adiponectin into routine testing panels. It also allows for detailed patient testing profiles through increased testing range and without the manual restrictions placed by running ELISA techniques.

Randox is presently the only diagnostic manufacturer who has a globally available automated biochemistry test for adiponectin measurement.

14th September 2017

Randox Automated Adiponectin Assay

The Randox adiponectin assay principle:

  • The sample is reacted with a buffer and anti-adiponectin coated latex
  • The formation of the antibody-antigen complex during the reaction results in an increase in turbidity – this is measured as the amount of light absorbed at 570nm.
  • A sample with higher adiponectin levels will contain more adiponectin and so more antibody-antigen complexes will be formed and the increase in turbidimetry
  • By constructing a standard curve from the absorbance of the standards, the adiponectin concentration of the sample can be determined.

Benefits of Randox adiponectin:

  • A niche product meaning we are one of the only manufacturers to provide the adiponectin test in an automated biochemistry format
  • Automated assay removing inconvenience and time consumption associated with traditional ELISA testing
  • Applications available for a wide range of automated biochemistry analysers ensuring ease of programming and confidence in results
  • Latex Enhanced Immunoturbidimetric method delivering high performance
  • Extensive measuring range for measurement of clinically important results
  • Complementary controls and calibrators available offering a complete testing package

The Randox automated immunoturbidimetric adiponectin test offers an improved method for assessing T2DM risk, with a convenient format for routine clinical use, to enable physicians to accurately evaluate at-risk individuals.

Please contact us at reagents@randox.com for more information!

Download our white paper from the resource hub.


Prepare for a stroke or take action to prevent one?

“If you experience any neurological symptom that comes on suddenly and is unfamiliar (eg not like your normal migraine) then you should seek urgent medical advice. And take an Aspirin (unless you’re allergic to it).” That’s the advice today from Dr Mark Porter, writing in The Times about what to do in the event you think you’re suffering a stroke.

It’s good advice to keep a packet in your medicine cabinet, but did you know that it’s thought 91% of strokes are avoidable?

What is a stroke?

For the brain to function properly, it needs the oxygen and nutrients provided by the blood. Stroke occurs when a blood vessel in the brain bursts or, more commonly, when a blockage develops which leaves the supply of the blood to the brain limited or completely obstructed and without treatment, cells in the brain quickly begin to die.

There are 3 different types of stroke:

  1. Ischaemic Stroke
  2. Haemorrhagic Stroke
  3. Transient Ischaemic Attack (TIA)

Avoidable risk factors

Research was carried out by McMaster University Canada – it compared the lifestyles of people who had a stroke with those who had not, involving nearly 27,000 participants from 32 countries. It found that 9 out of 10 strokes worldwide could be caused by risk factors – many of which can be avoided:

  • Lowering blood pressure
  • Exercising
  • Eating healthily
  • Maintaining a healthy weight
  • Preventing diabetes
  • Lowering cholesterol
  • Cutting down on alcohol
  • Stopping smoking
  • Lowering stress
  • Taking preventive medication for any heart arrhythmia

The most important modifiable risk is high blood pressure, increasing the risk by 47.9%, which is why it’s the key target across the world for reducing strokes.

Randox Health can help

Randox Health clinics offer you personalised preventive health programmes that provide a full profile of your entire body’s health, including diabetes health, lung health, liver health, heart health and many more areas. Upon receiving your results, you are given a programme to follow to help improve any areas of your health which are not ‘in the green’ on our scale. This helps you to prevent future illnesses and any unwanted surprises such as a stroke. We’ve helped over 3000 people in our clinics to date – book your test today.


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