Components of a Cardiac Risk Panel
A standard cardiac risk panel includes total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, and high-sensitivity C-reactive protein (hs-CRP) as the core components for assessing cardiovascular disease risk. 1
Core Components of the Cardiac Risk Panel
Lipid Profile:
- Total cholesterol
- High-density lipoprotein (HDL) cholesterol
- Low-density lipoprotein (LDL) cholesterol
- Triglycerides
Inflammatory Marker:
- High-sensitivity C-reactive protein (hs-CRP)
Additional Biomarkers Often Included
These additional markers may be included in expanded cardiac risk panels based on clinical context:
- Apolipoprotein B (ApoB) - provides information about the total number of atherogenic particles 1
- Lipoprotein(a) [Lp(a)] - an independent genetic risk factor for cardiovascular disease 1
- Non-HDL cholesterol - represents both LDL and remnant cholesterol combined 2
- Lipoprotein-associated phospholipase A2 (Lp-PLA2) - an inflammatory marker associated with plaque instability 1
Risk Assessment Application
The results from these laboratory tests are typically incorporated into risk assessment algorithms such as:
- Pooled Cohort Equations - calculates 10-year risk of atherosclerotic cardiovascular disease (ASCVD) 1
- Framingham Risk Score (FRS) - traditional risk calculator that includes lipid parameters 1
Clinical Context for Testing
Cardiac risk panel testing is most beneficial for:
- Individuals with intermediate risk based on traditional risk factors 1
- Patients with family history of premature cardiovascular disease
- Those with multiple cardiovascular risk factors but without established disease 1
Interpretation Considerations
- The American College of Cardiology/American Heart Association guidelines recommend measuring and updating ASCVD risk factors every 4-6 years to improve risk prediction 2
- Risk assessment should incorporate both traditional lipid parameters and inflammatory markers for comprehensive evaluation 3, 4
- The hs-CRP/HDL-C ratio has emerged as a potentially valuable inflammation-lipid composite marker for cardiovascular disease risk prediction 4
Limitations and Caveats
- Fasting lipid profiles provide more accurate assessment than non-fasting levels, particularly for triglycerides 2
- Secondary causes of lipid abnormalities (medications, alcohol, diabetes, hypothyroidism) should always be evaluated 2
- While advanced lipid testing (such as particle size analysis) may provide additional information, these are not routinely included in standard cardiac risk panels 3
The cardiac risk panel serves as a fundamental tool for cardiovascular risk assessment, helping clinicians identify patients who may benefit from more aggressive preventive interventions to reduce morbidity and mortality from cardiovascular disease.