Pre-Statin Workup Panel

Personalized Risk Assessment Before Starting Statin Therapy

Before deciding on statin treatment, it’s important to get a clear picture of your actual cardiovascular and metabolic risk. These tests go beyond standard cholesterol panels and help determine whether statins are truly necessary – or if lifestyle or other interventions may be more appropriate.

– Lipid Particle Risk

– ApoB: Measures the number of atherogenic particles

– LDL-P (LDL particle number): More accurate than LDL-C for predicting risk

– Lp(a) – Lipoprotein(a): Inherited risk factor for heart attack/stroke

– Small, dense LDL: Smaller particles are more dangerous

– HDL Subfractions: Evaluates quality of “good” cholesterol

– Inflammation

– hs-CRP (high-sensitivity CRP): Marker of vascular inflammation

– Oxidized LDL: Detects LDL most likely to cause arterial damage

– Atherosclerosis Burden

– Coronary Artery Calcium (CAC) Score: CT scan that reveals hidden plaque (non-blood test)

– Metabolic Health

– Fasting Insulin: Helps assess insulin resistance

– HOMA-IR: Calculates insulin resistance from glucose/insulin

– Triglyceride:HDL Ratio: High ratio suggests insulin resistance

– Vascular Risk Markers

– Homocysteine: Elevated levels increase clotting and vascular risk

– Optional Genetic Tests

– SLCO1B1 genotype: Predicts statin side effect risk (myopathy)

– ApoE genotype: Influences cholesterol metabolism

– LPA genotype: Identifies inherited high Lp(a)

Example Lab Panels That Include These Tests

– Cleveland HeartLab – Cardio Risk Panel + hs-CRP Pre-Statin Workup Panel

Personalized Risk Assessment Before Starting Statin Therapy

– Quest Diagnostics – Cardio IQ Advanced Lipid Panel

– LabCorp – NMR Lipoprofile + Inflammation Panel

– Genova Diagnostics – CardioMetabolic Panel

– Boston Heart Diagnostics – Cholesterol Balance + Inflammation

Why This Matters

These advanced tests allow you and your doctor to:

– Avoid unnecessary medications

– Target personal risk factors

– Identify whether inflammation or genetics are driving your numbers

– Monitor progress if you choose nutrition or lifestyle changes first

Discuss With Your Doctor:

– What’s my LDL-P or ApoB level?

– Is my Lp(a) elevated?

– Can we check a CAC score before starting a statin?

– Am I at high risk due to inflammation or insulin resistance?

“Treat the person, not just the cholesterol number.”