Cardiovascular risk & prevention

Traditional methods for assessing cardiovascular risk focus on conventional factors such as LDL-C levels, blood pressure, smoking, and family history. These metrics guide preventive measures but may not fully capture residual risk, highlighting the need for expanded panels that include Lipoprotein (a) [Lp(a)] for more accurate assessment, as recommended by international guidelines. 
 

Are you integrating LP(a) in your evaluations?

Lp(a) is recognized as a risk factor for cardiovascular disease. Its associated risk is independent of LDL-C and is attributed from the atherogenic, proinflammatory, and prothrombotic characteristics of Lp(a).^3-5

High levels should prompt early and intensive risk factor management, including lifestyle modifications and lipid-lowering therapies.
 

Recently, a calculator has been presented to help calculate life-long cardiovascular risk and the impact of risk factor management. Measuring Lp(a) is now considered an essential component of comprehensive cardiovascular risk evaluation.^6,7

LP(a) for reliable and accurate assessment of cardiovascular risk

Heart failure is a frequent condition that affects approximately 2% of Belgians with an annual incidence of 15,000 new cases.

The average age at diagnosis is 69 years (Belgian Cardiological League figures – 2016)⁸ and 75% of patients in Belgium are diagnosed in NYHA class III or IV.⁹ Over a quarter (26%) of heart failure patients die within the first year of diagnosis, and nearly half (46%) die within five years.⁸
 

Early Detection for better outcomes

Heart failure is difficult to diagnose in any setting, but it is particularly challenging in primary care due to the non-specific nature of symptoms like breathlessness, fatigue, and ankle swelling.¹⁰ However, early recognition and intervention are essential to improving quality of life, reducing hospitalisations, and increasing survival rates for these patients. 

NT-proBNP is a valuable biomarker that rises in response to increased pressure within the heart, making it useful for diagnosis of heart failure and for assessing the prognosis of chronic heart failure. This helps general practitioners provide better care for their patients.¹¹

Explore the website of the Belgian Working Group for Heart Failure for more information on heart failure management in Belgium.
 

Diabetes & Heart Failure—A Vital Link

Special attention should be given to patients with type 2 diabetes, as heart failure (HF) is one of the earliest, most common, and serious cardiovascular complications in diabetes.^12-15 Early identification allows for timely cardioprotective treatments, preventing hospitalisations and improving quality of life.^16-18 Please refer to the brochure on the right for more information on managing heart failure in diabetic patients.

Proactive heart failure risk assessment for people with type 2 diabetes

Traditional methods for assessing cardiovascular risk focus on conventional factors such as LDL-C levels, blood pressure, smoking, and family history. These metrics guide preventive measures but may not fully capture residual risk, highlighting the need for expanded panels that include Lipoprotein (a) [Lp(a)] for more accurate assessment, as recommended by international organisations such as the European Atherosclerosis Society (EAS) and the European Society of Cardiology (ESC).<sup>19,20

Are you integrating LP(a) in your evaluations?</sup>

Lp(a) has been recognized as a significant risk factor for cardiovascular disease. The risk associated with Lp(a) is independent of LDL-C and is attributed to the atherogenic, proinflammatory, and prothrombotic properties of Lp(a).

High levels should prompt early and intensive risk factor management, including lifestyle modifications and lipid-lowering therapies.

Furthermore, Lp(a)-lowering therapies currently under development are being investigated for their potential to help manage high Lp(a) levels in the future.

Recently, a calculator has been presented to help estimate life-long cardiovascular risk and the impact of risk factor management. Measuring Lp(a) is now considered an essential component of comprehensive cardiovascular risk evaluation, aligning with contemporary best practices in cardiology.^3-7

LP(a) for reliable and accurate assessment of cardiovascular risk

Patients with type 2 diabetes (T2D) are at a significantly higher risk of developing heart failure (HF), a common, prevalent cardiovascular complication that occurs early and impacts up to 22% of individuals with diabetes. This risk is further heightened by the increasing global prevalence of diabetes, which has grown by 30% over the past decade and is expected to rise further, intensifying the burden on healthcare systems.

Predicting HF risk in T2D patients remains difficult, as existing models often underperform due to the complex and diverse array of T2D-specific risk factors.²¹
 

NT-proBNP has also demonstrated superior prognostic ability to current prognostic methods like the ESC/EASD risk model, SCORE (risk model), albuminuria and HbA1c.^22-24

Major international guidelines, including those from the ADA, AHA/ACC/HFSA, and ESC, recommend the use of NT-proBNP for risk stratification in patients with type 2 diabetes or for evaluating suspected heart failure. This approach aids physicians in identifying individuals at increased risk of HF and supports cardiovascular risk assessment to determine the need for optimization of cardioprotective treatments.^{21, 25-27}

In Belgium, establishing a national consensus on the early identification of T2D patients at risk of HF would help ensure consistent and effective cardioprotective strategies across the healthcare system. 

Proactive heart failure risk assessment for people with type 2 diabetes

NT-proBNP plays an important role in the diagnosis and management of heart failure. It is a peptide released by the heart muscle when it is stretched, and serves as an essential biomarker for detecting heart failure early and accurately.

Elevated levels of NT-proBNP indicate cardiac stress, aiding clinicians in diagnosing heart failure and differentiating it from other conditions with similar symptoms.¹¹

The Roche NT-proBNP assay offers significant benefits for clinical biologists. It is standardized and clinically validated across both point-of-care and core laboratory settings, ensuring consistency and reliability in test results. Moreover, the Roche NT-proBNP assay is the most studied on the market, providing robust data supporting its efficacy. Its broad intended use makes it a comprehensive tool for cardiovascular risk assessment and heart failure management.²⁸

Explore the advantages of integrating the Roche NT-proBNP assay into your diagnostic practice to enhance patient outcomes and streamline heart failure diagnosis.

Why use Roche’s NT-proBNP assays over BNP options?

Lipoprotein (a) [Lp(a)] is increasingly recognized as an independent risk factor for cardiovascular diseases, making it a critical component of comprehensive cardiovascular risk assessment. Elevated Lp(a) levels contribute to cardiovascular risk through atherogenic, proinflammatory, and prothrombotic pathways, regardless of LDL-C levels.^3-5

Structurally, Lp(a) consists of an LDL-like particle and an additional apolipoprotein(a) [apo(a)] protein, which varies greatly among individuals due to genetic differences. This significant variability in apo(a) size affects both the atherogenic potential and the ease of accurate measurement.⁵

Clinical guidelines strongly emphasize measuring Lp(a) concentrations in nanomoles per liter (nmol/L) and advise against converting from mass concentration (mg/dL). The conversion between these units is inaccurate due to the major variation in apo(a) size among different individuals.^19,20 In light of these guidelines, Roche Diagnostics offers advanced solutions for accurately measuring Lp(a), enabling clinical biologists to perform reliable assessments and contribute to preventive cardiology practices.

LP(a) for reliable and accurate assessment of cardiovascular risk

To help prevent cardiovascular diseases, you can adapt your lifestyle by focusing on well known risk factors: eat healthily, exercise regularly, avoid smoking, maintain a healthy weight and limit the use of alcohol.

Together with your doctor you can monitor your health with regular checks that can include a blood pressure measurement and a taking a blood sample to evaluate cholesterol levels and other biomarkers.
 

A biomarker (short for biological marker) is an objective measure that captures what is happening in a cell or an organism at a given moment. Biomarkers can serve as early warning systems for your health. For example, high cholesterol levels are a common biomarker for heart disease risk.²⁹
 

Biomarkers are crucial in diagnosing cardiovascular diseases, assessing risks, evaluating prognosis, monitoring treatment effectiveness, etc. Roche Diagnostics uses advanced biomarker technology to help detect heart damage, stress, and inflammation, aiding in personalized heart health management.

Take proactive steps today for a healthier heart. Visit the resources below for more information.