Overview
Boston Heart HDL Map ® Test
For more than forty years, total circulating HDL cholesterol (HDL-C) has been used as a primary indicator of cardiovascular disease (CVD) risk. However, HDL is comprised of subpopulations of different sizes, composition and characteristics that impact cardiovascular risk in drastically different ways.
Data from the Framingham Heart Study, Framingham Offspring Study, Veterans Affairs HDL Cholesterol Intervention Trial (VA-HIT) and HDL-Atherosclerosis Treatment Study (HATS) have shown that HDL subpopulations are significantly better predictors of CVD risk than HDL-C values alone.
The Boston Heart HDL Map® is the only test available that quantifies the amount of apoA-I in the five most significant subpopulations, resulting in a deeper understanding of a patient’s CVD risk. This exclusive method provides healthcare providers with an accurate and consistent indication of reverse cholesterol transport by separating the larger, cardioprotective particles most associated with decreased CVD risk from the smaller HDL particles associated with increased risk. Healthcare providers can use this information to determine the most effective treatment strategy, as well as monitor response to therapy.
Test Details
Boston Heart HDL Map ® Test
The Boston Heart HDL Map® test measures the five most significant HDL subpopulations in CVD risk using a proprietary gel electrophoresis technique. This process quantifies the amount of apoA-I protein in each of the five HDL subclasses, providing information to accurately identify patients at increased CVD risk.
Methodology
Proprietary PAGE system
Patient Preparation
Fasting is preferred.
Preferred Specimen
1.0 mL EDTA plasma (0.5 mL minimum) collected in plasma separator tube (Pearl Top)
Transport Temperature
Refrigerated (ship on frozen cold packs)
Stability
Refrigerated: 2 days (sample must be received within 2 days of collection)
Lab Values
Boston Heart HDL Map ® Test
Values are the concentration of apoA-1 in each subparticle.
Male
| Optimal | Borderline | Increased Risk | |
|---|---|---|---|
| mg/dL | |||
| α-1 | >35.0 | 25.0-35.0 | <25.0 |
| α-2 | >55.0 | 45.0-55.0 | <45.0 |
| α-3 | <20.0 | 20.0-25.0 | >25.0 |
| α-4 | <20.0 | 20.0-25.0 | >25.0 |
| Preβ-1 | <20.0 | 20.0-25.0 | >25.0 |
Female
| Optimal | Borderline | Increased Risk | |
|---|---|---|---|
| mg/dL | |||
| α-1 | >45.0 | 35.0-45.0 | <35.0 |
| α-2 | >65.0 | 55.0-65.0 | <55.0 |
| α-3 | <20.0 | 20.0-25.0 | >25.0 |
| α-4 | <20.0 | 20.0-25.0 | >25.0 |
| Preβ-1 | <20.0 | 20.0-25.0 | >25.0 |
Clinical Significance
Boston Heart HDL Map ® Test
Low α-1 level is a significant predictor of recurrent CVD events1
- Low levels of α-1 HDL and high levels of pre ß-1 HDL predicted recurrent CVD events versus no recurrence in men selected for low HDL-C (<40 mg/dL) and CVD. Low α-1 HDL levels have been shown to be the most significant parameter predicting CVD recurrence (p<0.001).1
References:
1. Asztalos BF, Cupples LA, Demissie S, Horvath KV, Cox CE, Batista MC, Schaefer EJ. High-density lipoprotein subpopulation profile and coronary heart disease prevalence in male participants in the Framingham Off spring Study. Arterioscler Thromb Vasc Biol. 2004; 24(11):2181-2187.
Treatment Options
Boston Heart HDL Map ® Test
- Lifestyle modification (if indicated)
- Low saturated fat (<7%)
- Low cholesterol (<200 mg/day)
- Low sugar
- Exercise >30 minutes per day
- Smoking cessation
- Weight reduction (if indicated)
- Medications and their impact on HDL Particles
