When assessing your patients’ risk for coronary heart disease (CHD), your clinical suspicions may be higher than their clinical risk scores.

Introducing the PLAC® Test for Lp-PLA2 Activity (PLAC® Activity)

The PLAC® Activity Test is an FDA-cleared test that aids in predicting risk for CHD in patients with no prior history of cardiovascular events. The PLAC Activity Test provides physicians with additional prognostic information that was previously unavailable with traditional risk factors.

Assessing patients' risk for CHD events remains a challenge in primary prevention

  • Patients with low and moderate CHD risk still have a significant risk for events over 10 years1
  • In a large cohort of patients hospitalized with coronary artery disease, nearly 50% had admission LDL levels <100 mg/dL2
  • When assessing CHD risk, cholesterol testing alone is not always enough3

Event risk prediction with the PLAC Activity Test

  • Novel risk prediction for CHD in patients with no prior history of cardiovascular events
  • Prognostic value independent of standard lipid profile testing
  • Use in conjunction with clinical evaluation and patient risk assessment
  • Incorporates a validated and easy-to-use cut point of 225 nmol/min/mL

Demonstrated across multiple clinical trials and patient populations

  • The greater the Lp-PLA2 activity, the greater the risk for fatal and nonfatal CHD events(Figure 1)
  • A PLAC Activity Test result above 225 nmol/min/mL identifies patients at increased risk for CHD events across patient type and population (Figure 2)
  • Absolute risk for CHD events is 2.1 times greater with a positive PLAC Activity Test result (Figure 2)

The REGARDS± multicenter study and the PLAC Activity Test

  • One of the largest National Institutes of Health (NIH) studies ever undertaken, with over 30,000 patients enrolled across the United States
  • The Lp-PLA2 substudy examined 4,598 case-matched patients
  • A cut point of 225 nmol/min/mL was prospectively assigned based on prior studies and publications
  • In a REGARDS multicenter substudy, high Lp-PLA2 activity was more closely associated with outcome than high low-density lipoprotein cholesterol (LDL) and low high-density lipoprotein cholesterol (HDL). Only status of diabetes or smoking was more closely associated with events (Figure 3)

±REasons for Geographic and Racial Differences in Stroke.

Figure 3

The PLAC Activity Test is clearly associated with CHD event risk end points

  • Patients with a positive PLAC Activity Test result are at high risk for first-time myocardial infarction, cardiac revascularization, and cardiac death (Table 1)
  • At the cut point of 225 nmol/min/mL, the primary composite end point of risk for CHD events was reached (Figure 4)
  • The cut point of 225 nmol/min/mL achieved statistical significance for each individual risk component (Table 1)

References: 1. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001;285(19):2486-2497. 2.Sachdeva A, Cannon CP, Deedwania PC, et al. Lipid levels in patients hospitalized with coronary artery disease: an analysis of 136,905 hospitalizations in Get With The Guidelines. Am Heart J. 2009;157(1):111-117.e2. 3. US Preventive Services Task Force. Final recommendation statement: lipid disorders in adults (cholesterol, dyslipidemia): screening, June 2008. http://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/lipid-disorders- in-adults-cholesterol-dyslipidemia-screening#. Published December 2014. Accessed April 29, 2015. 4. Thompson A, Gao P, Orfei L, et al; Lp-PLA2 Studies Collaboration. Lipoprotein-associated phospholipase A2 and risk of coronary disease, stroke, and mortality: collaborative analysis of 32 prospective studies. Lancet. 2010;375(9725):1536-1544. 5. PLAC® Test for Lp-PLA2 Activity [package insert]. South San Francisco, CA: Diadexus, Inc; 2015. 6. 3rd Annual American Society for Preventive Cardiology Cardiovascular Disease Preventive Conference, 2015. Symposium of REGARDS Lp-PLA2 Substudy.