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Blood Work Done. What Are The Risks. Should I Go For Cardiologist Advice?

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Posted on Sat, 4 Aug 2012
Question: Hello. My recent blood panel showed an elevated MCHC of 36.4.
Also my C Reactive Protein was 3.5.
and my VLDL3 was 11.
Al of the above came with a "High Risk" warning.
I also show my LP(a) to be elevated to 11. And my LP-PLa2 elevated to 210.73
What are the risks, how should they be addressed? I see a cardiologist but would love to learn more.
Thank you.
doctor
Answered by Dr. Anil Grover (3 hours later)
Hi,
Thanks for writing in.
I am a qualified and certified cardiologist. I read your mail as well as back ground. You have some conventional risk factors for CAD which can see from the table below.
Folic Acid Deficiency, usually in elderly, leads to macrocytic anemia with increased MCHC, leads to elevated seum homocysteine which is unconventionally measured risk factor for coronary artery disease as well as for some cancers.
Elevated VLDL 3, CRP >3.5 elevated Lipoprotein a and increased Lipoprotein a Liporprotein ratio here given as 11 and 210.73 are also elvevated meaning high risk for Coronary Artery Disease(CAD). Here, two points to be noted.

Risk of elevation of Homocysteine as a result of Folic Acid Deficiency can be reversed by adequate intake of Folic Acid per se.
Whereas, Lipoprotein a LPa - force multiplier for risk factors, diabetes , says confer x risk to a person for CAD in presence of LPa it increases nanifold. No specific drug is known for treating lipoprotein a level.
CRP in general reflects high risk group for CAD. Treatment of cholesterol and lipid component risk factors like LDL, etc will take care of CRP.
Conventional Risk Factors with which above Risk factors accumulate:
A: MODIFIABLE RISK FACTORS
Diabetes +/-
Hypertension*
Smoking+/-
Stress+/-
Obesity and Sedentary Life Style+/-
High Bad Cholesterol and Lipid Component *
Total Cholesterol above 190 mg%, LDL above 130 mg%, VLDL above 40 mg%,
Triglycerides above 150 mg%, Apolipoprotein B above reference value
Low Good Cholesterol and Lipid Component: *
Apolipoprotein a below reference range for the lab and
HDL below 40 mg% for man & and 50 mg% for woman
B: NON MODIFIABLE RISK FACTORS
Family History 0f Coronary Heart Disease +/-
Increasing age*
Being a Man (as opposed to women) till the age 45*
* for sure you have this risk factor and +/- means we do not as yet. I urge you to eat the doctor, by ordering few more investigations he will complete your CAD risk profile.
Homocysteinemia has been associated with oncogenic risk. This study was designed to investigate the homocysteine (Hcy) genotype/phenotype interactions together with the inflammatory and nutritional status of cancer patients.Cancer-related inflammation may be associated with elevated tHcy levels, possibly involving a Tumor Necrosis Factor-alpha mediated pathway.


With Best Wishes
Dr Anil Grover,
Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Anil Grover

Cardiologist

Practicing since :1981

Answered : 922 Questions

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Blood Work Done. What Are The Risks. Should I Go For Cardiologist Advice?

Hi,
Thanks for writing in.
I am a qualified and certified cardiologist. I read your mail as well as back ground. You have some conventional risk factors for CAD which can see from the table below.
Folic Acid Deficiency, usually in elderly, leads to macrocytic anemia with increased MCHC, leads to elevated seum homocysteine which is unconventionally measured risk factor for coronary artery disease as well as for some cancers.
Elevated VLDL 3, CRP >3.5 elevated Lipoprotein a and increased Lipoprotein a Liporprotein ratio here given as 11 and 210.73 are also elvevated meaning high risk for Coronary Artery Disease(CAD). Here, two points to be noted.

Risk of elevation of Homocysteine as a result of Folic Acid Deficiency can be reversed by adequate intake of Folic Acid per se.
Whereas, Lipoprotein a LPa - force multiplier for risk factors, diabetes , says confer x risk to a person for CAD in presence of LPa it increases nanifold. No specific drug is known for treating lipoprotein a level.
CRP in general reflects high risk group for CAD. Treatment of cholesterol and lipid component risk factors like LDL, etc will take care of CRP.
Conventional Risk Factors with which above Risk factors accumulate:
A: MODIFIABLE RISK FACTORS
Diabetes +/-
Hypertension*
Smoking+/-
Stress+/-
Obesity and Sedentary Life Style+/-
High Bad Cholesterol and Lipid Component *
Total Cholesterol above 190 mg%, LDL above 130 mg%, VLDL above 40 mg%,
Triglycerides above 150 mg%, Apolipoprotein B above reference value
Low Good Cholesterol and Lipid Component: *
Apolipoprotein a below reference range for the lab and
HDL below 40 mg% for man & and 50 mg% for woman
B: NON MODIFIABLE RISK FACTORS
Family History 0f Coronary Heart Disease +/-
Increasing age*
Being a Man (as opposed to women) till the age 45*
* for sure you have this risk factor and +/- means we do not as yet. I urge you to eat the doctor, by ordering few more investigations he will complete your CAD risk profile.
Homocysteinemia has been associated with oncogenic risk. This study was designed to investigate the homocysteine (Hcy) genotype/phenotype interactions together with the inflammatory and nutritional status of cancer patients.Cancer-related inflammation may be associated with elevated tHcy levels, possibly involving a Tumor Necrosis Factor-alpha mediated pathway.


With Best Wishes
Dr Anil Grover,
Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW