Breaking News. Heart Health Updates

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1 The Times Better Healthcare through Better Service & Better Science October 2015 Volume 2 Special Edition For Internal Use Only Breaking News Updates by Katie Carrera Imminent Changes to Effective Monday, November 2, 2015, we are pleased to announce the release of our enhanced Profiles, including the new to replace the NMR LipoProfile. The following codes will AUTOMATICALLY be converted to include the new profile components when ordered: Comprehensive Baseline Profile, Test Code F306-6 Comprehensive Monitoring Profile, Test Code F307-4 Baseline Profile, Test Code Q471-5 Monitoring Profile, Test Code Q472-3 Please note: The NMR LipoProfile will no longer be available as an individual test. Additionally, due to clinical relevance, the new will only be available when ordered as part of one of the Profiles. The Lipoprotein Particle Evaluation cannot be ordered as a stand-alone test.. In Brief: Lipoprotein Particle Evaluation The new measures the four key components for accurate assessment of cardiovascular risk and treatment, as outlined by the National Cholesterol Education Program (NCEP): Small-dense LDL, Remnant Lipoprotein (RLP), Lp(a) and Large-Buoyant HDL2b. This comprehensive risk assessment: Helps identify the 50 percent of patients that are at risk for cardiovascular disease but have normal cholesterol levels Accurately measures the lipoprotein subgroups of VLDL, LDL and HDL Directly measures lipoprotein particle numbers and density (which directly correlate to size) Counts lipoprotein particles using proprietary technology During a mandatory training either in-person tomorrow or via WebEx on Friday (see timeline below), you will learn additional information about the new. You should also refer to and review the various marketing pieces (see Collateral Corner) for additional information.

2 BioReference Laboratories, Inc. James Weisberger, M.D. Clinical Page 1 of 5 Noteworthy Changes In addition to the enhancements within the evaluation and profiles, other changes include: Report: Evaluation results will be reported out in full color on the first page of the report, and the report will now have the option to include an assessment graph that can be used as a visual patient education tool. At the time of launch, the graph will be an opt-in feature, so will need to be requested through Sales Support to be included. Each report also presents clinical suggestions and therapeutic recommendations. This feature will be automatically included on the report, but clients will have the option to opt-out and turn the feature off if requested through Sales Support. Sample Report Final Report Final Report 100 Test Street Houston, TX Acct #: (J3333-7) 11 P: (201) DOB: Address: NJ P: Age:55 Y Sex:M Specimen ID: Date Of Report: 09/25/2015 Date Collected: 09/24/2015 Time Collected: Date Received: 09/24/2015 Time Received: 15: Test Street Houston, TX Acct #: (J3333-7) 11 P: (201) DOB: Address: NJ P: Age:55 Y Sex:M Specimen ID: Date Of Report: 09/25/2015 Date Collected: 09/24/2015 Time Collected: Date Received: 09/24/2015 Time Received: 15:18 North America Central Time North America Central Time Basic Lipid Evaluation Low Moderate Total Cholesterol 150 mg/dl < >239 Triglycerides 81 mg/dl < >199 HDL-C, Direct 67 mg/dl > <20 HDL-C as % of Total Cholesterol 45% > <9 Cholesterol/HDL-C Ratio 2.2 < >11.5 LDL/HDL-C Ratio 1.70 < >8.00 Non-HDL Cholesterol 83 mg/dl < >189 VLDL Cholesterol 16 mg/dl < >40 LDL-C Direct 114 mg/dl < >160 Low Moderate VLDL Particles 38 nmol/l < >100 Total LDL Particles 864 nmol/l < >900 Non-HDL Particles 902 nmol/l < >1000 RLP - Remnant Lipoprotein 69 nmol/l < >175 Small - Dense LDL III 276 nmol/l < >350 Small - Dense LDL IV 107 nmol/l < >115 Total HDL Particles 6885 nmol/l > <7000 Large - Bouyant HDL 2b 1307 nmol/l > <1500 Independent Factors Low Moderate hs-crp 3.5 mg/l < >3.0 Hemoglobin A1c <4.3% < >6.5 Note: Refer to clinical report for performing laboratories. High High High Previous Result Date Previous Result Date Previous Result Date Assessment Graph Assessment Graph Interpretation Notes 1. Patient values (black line) should ideally only appear in the green area of the graph. Yellow areas represent borderline values; red indicates abnormal values. 2. Remnant lipoproteins (RLP) are highly atherogenic and correlate to CHD (NCEP guidelines). 3. LDL class III and IV elevations indicate an abundance of small dense atherogenic LDL particles. 4. LDL classes I and II are larger and more buoyant then classes III and IV and hence less atherogenic. 5. LDL values to the left of the vertical dotted line are less atherogenic than those to the right. 6. Remnant lipoprotein particles (VLDL3+IDL) do not require oxidation to be absorbed by foam cells as precursors to plaque formation % of Total HDL should be the HDL 2b fraction. 8. Elevated amounts of HDL 2b may overlap with LDL IV causing apparent elevations of LDL IV. BioReference Laboratories, Inc. James Weisberger, M.D. Clinical Page 2 of Test Street Houston, TX Acct #: (J3333-7) 11 P: (201) Final Report DOB: Address: NJ P: Age:55 Y Sex:M Therapeutic Guidelines [1][2][3][4] Specimen ID: Date Of Report: 09/25/2015 Date Collected: 09/24/2015 Time Collected: Date Received: 09/24/2015 Time Received: 15:18 North America Central Time Basic Lipid Evaluation Triglycerides Interpretation for: Triglycerides are a type of blood lipid (fat). A normal level for fasting triglycerides is <150 mg/dl. High levels of triglycerides, hypertriglyceridemia, is a component of etabolic syndrome, which is a disorder of metabolism associated with hypertriglyceridemia, high blood pressure, obesity, elevated blood sugar, and low HDL ("good") cholesterol. Lowering the triglyceride level is managed by a low fat diet, weight loss, exercise, and possibly medication. Significant hypertriglyceridemia (>500 mg/dl) is associated with a risk of pancreatitis. HDL, Direct HDL is commonly known as the "good" cholesterol. It is usually reported as a measured value. High HDL helps clear the "bad" cholesterol (LDL) from blood and reduce the risk of atherosclerotic cardiovascular disease (ASCVD). High levels of HDL can protect against a heart attack. Cholesterol/HDL Ratio The ratio is important in determining risk for ASCVD. It is obtained by dividing the total cholesterol by the HDL cholesterol. A desirable ratio is below 5(5:1); the optimum ratio is 3.5(3.5:1). LDL, Direct Direct LDL is a better measure than the normally calculated LDL especially in patients with hypertriglyceridemia and diabetes. Elevated levels of LDL, as measured with the Direct LDL, indicate a greater risk of developing ASCVD. LDL levels can be decreased by lifestyle changes and/or medication. Non-HDL Cholesterol (LDL & VLDL) Non-HDL is used as a treatment target for cholesterol especially in patients with diabetes or metabolic syndrome. Increasing levels of non-hdl correspond to a higher risk of ASCVD. VLDL Particles A high VLDL Particle (VLDL >85 nmol/l) correlates to triglyceride values of over 200 mg/dl, high RLP, and possible metabolic syndrome. There is no reported clinical guidance by NCEP Total LDL Particles The higher the number of LDL particles, the greater risk for developing ASCVD. A patient can have a normal cholesterol level, but may be at an increased risk for ASCVD if they have a borderline, high to very high LDL particle number (LDL >700, 900, 1100 nmol/l). Patients with 2 or more risk factors are recommended to initiate therapeutic lifestyle changes and/or drug therapy to lower LDL <900 nmol/l. Patients with CHD or CHD equivalents are recommended to begin LDL-lowering drug therapy to LDL <700 nmol/l. All patients with LDL particle numbers greater than 1100 nmol/l are recommended to be treated aggressively. RLP - Remnant Lipoprotein Remnant Lipoprotein (RLP) is an atherogenic lipoprotein and a new NCEP risk factor that has been shown to be highly correlated with CHD. It is believed to be a building block of plaque since it does not need to be oxidized like the rest of LDL, and should be monitored along with other risk factors during lifestyle, supplement and/or drug treatment. An elevated level of RLP is >150 nmol/l. Omega-3 fatty acids have been shown to reduce triglycerides and RLP. Small - Dense LDL III These particles are associated with an increased risk of ASCVD. A lower score is associated with a lower risk. A borderline to high LDL III particle number (LDL III >200 nmol/l) indicates an abundance of small, dense atherogenic LDL particles that can easily penetrate the arterial endothelium and cause plaque formation. Management should be considered depending on LDL-C goals and risk factors. Reducing LDL-C and TG often will lower dense-ldl particles. Small - Dense LDL IV An elevated LDL IV (LDL IV >100nmol/L) level indicates the abundance of very small dense atherogenic particles. Lowering of LDL IV may also lower your Lp(a), which is genetically determined. Elevated LDL IV may also be due to high buoyant (large) HDL 2b, which in females may be related to good fitness. Total HDL Particles The higher number of HDL particles, the lower risk for ASCVD. The lowest risk for atherosclerotic events has been associated with highest concentrations of HDL particles. A low HDL particle count is <7000 nmol/l, nmol/l is borderline for males and females. This indicates potential for atherogenic dyslipidemia. Beneficial therapies are similar to those which raise HDL-C and reduce elevated TG (diet, exercise, omega-3s). BioReference Laboratories, Inc. James Weisberger, M.D. Clinical Page 3 of 5 BioReference Laboratories, Inc. James Weisberger, M.D. Clinical Page 4 of 5 Laboratory: The test is validated at the New Jersey laboratory and will now be run-in house. It will no longer be a send-out to a reference lab. Our partner, SpectraCell Laboratories, developed the proprietary technology and BioReference is the exclusive licensee of the test in the United States. noteworthy changes continues

3 ...more Noteworthy Changes S pecimen Requirements: The new profiles will require an SST and Lavender Top only. The Black and Yellow Lipotube will no longer be required. Components and Specimen Requirements Profiles Comprehensive Baseline Profile Test Code F306-6 CBC w/diff; CMP LP(a); hs-crp; HbA1c Baseline Profile Test Code Q471-5 LP(a); hs-crp; HbA1c Comprehensive Monitoring Profile Test Code F307-4 CBC w/diff; CMP Basic Lipid; LDL Direct hs-crp; HbA1c Monitoring Profile Test Code Q472-3 hs-crp; HbA1c S upplies: In an effort to reduce waste, we will continue to use old requisitions and kits until they are depleted in the warehouse. To reiterate messaging, the Announcement will be sent with all requested supply orders. Updated requisitions and kits are available and will roll out to clients over the coming weeks when they are requested for replenishment (and old versions have depleted). Communication Timeline D ue to the sensitive nature of our relationship with the reference lab that is currently running the NMR LipoProfile, internal and external communications have been strictly limited to a truncated and immediate roll-out timeline. To assist in the conversion, Marketing has planned various automatic means of communication. These include: a targeted fax announcement to clients that currently order impacted profiles; a memo included in the next client update that is distributed to all clients; a CareEvolve splash page; and an announcement sent along with all kits and requisition supply orders. In addition to the automatic communications that will be distributed, we ask that you please use the announcement and other sales tools (see Collateral Corner) to communicate the changes to your clients. This will help reinforce the message and allow you to be your clients source for information during this transition. TYPE ACTION DATE Sales Communication and Training Times Special Edition Wednesday Oct 28 Client Communication Announcement Fax Blast (To current clients using the profiles) Wednesday Oct 28 Memo in Client Update Fax Blast (To all clients) November CareEvolve Splash Page featuring Announcement Monday Nov 2 Monday Nov 30 Hard-copy Announcement to accompany supply orders for General/Medicare requisitions or kits Monday Nov 2 Monday Nov 30 Mandatory Sales Training. For local NY/NJ area reps the Thursday Oct 29 (in-person) training will be held in-person at the GlenPointe Marriott in and Friday Oct 30 (WebEx) Teaneck, NJ. For all other reps, the training will be via WebEx.

4 Your Responsibilities While a majority of the changes will be automatic and the conversion should be seamless, there are additional details that need to be communicated to your clients, dependent on their specific test utilization. At the training, your regional manager will provide you with 90-day client utilization reports of the four Profiles, as well as the NMR LipoProfile. With these lists, you should target communication to your clients to address the following details, either by office visit (preferable), phone call/message or . For clients that order any of the four Profiles: 1. Confirm all four panels are still available and codes will remain the same. The NMR component will automatically convert to the new. 2. Educate on the Lipoprotein Particle Profile Evaluation and the inclusion of relevant lipoprotein subgroups. 3. Discuss new report enhancements, including the available Assessment Graph and included Therapeutic Guidelines. 4. Inform clients on updated specimen requirements. The new profiles will only require an SST and Lavender Top, and will no longer include a Black and Yellow Lipotube. For clients that order 9690 NMR LipoProfile as an individual test or within their own custom panels: 1. Inform clients that use this code that the test will no longer be available. 2. Educate on the enhancements to the new Profiles and decide which will best suit the needs of the client. 3. If 9690 is included as a special pre-print for paper requisitions, make sure to communicate all necessary changes with Sales Support. As you can see, there are many moving parts to this transition. We ask that everyone thoroughly review all available content, and communicate with clients accordingly. We hope that the information included within this Special Edition of The Times will assist you in answering many of the questions your clients may have. Many teams have been working diligently behind-the-scenes to ensure this transition goes smoothly for your clients, but we need each of you to prioritize communicating the details of the conversion over the coming days. We see this as a true enhancement to our Program, and with your dedication and support, we are confident that the launch of our new Lipoprotein Particle Evaluation will be nothing short of a success.

5 Approximately 50% of people who are at risk of heart disease are not identified by routine testing. The unique testing by BioReference Laboratories supports better identification and treatment of the growing population of individuals with or at risk for atherosclerotic cardiovascular disease (ASCVD) through four clinically relevant panels. The patient-friendly report allows for improved treatment management, and promotes patient compliance with their care. now includes a Lipoprotein Particle Evaluation that measures the lipoprotein subgroups, allowing healthcare providers to accurately determine and diagnose cardiovascular risk in patients. gives physicians the option of incorporating a Global Calculation using Framingham, Reynold s or Pooled Cohort to assess patient risk for atherosclerotic cardiovascular disease (ASCVD) events. Historical data listed on the report allow physicians to quickly reference previous results and more easily monitor patient progress. HEART HEALTH TESTING FROM BIOREFERENCE LABORATORIES IS A COMPREHENSIVE APPROACH TO DIAGNOSING AND MANAGING PATIENTS WHO HAVE OR MAY BE AT RISK FOR HEART DISEASE. Markers HDL Cholesterol HDL Particle HDL2b Hemoglobin A1c hs-crp LDL Direct LDL Particle LP(a) Excess Remnant Lipoprotein (RLP) Small, dense LDL Relevance High Density Lipoprotein (HDL) slows arterial plaque buildup by transporting the cholesterol to the liver for disposal. The HDL particle number corresponds to the amount of bad cholesterol disposed by the liver. Therefore, the higher the number, the more cholesterol is disposed. Elevated levels of HDL2b and HDL3 are cardioprotective and are an indicator of how well excess lipids are removed from cells and transported back to the liver. Women tend to have higher levels than men. Reduced levels are associated with a risk of development of diabetes. Hemoglobin A1c (HbA1c) measures the average amount of sugar in your blood over a 3-month period and is used in the diagnosis and monitoring of diabetes. Diabetics are at an increased risk of ASCVD events. C-reactive protein (CRP) is an inflammatory protein; it is associated with inflammation of blood vessels and is associated with ASCVD, even in the absence of an elevated total cholesterol. Low Density Lipoprotein (LDL) can slowly build up in the inner walls of arteries, causing them to narrow. LDL particles transport cholesterol. The higher the number of LDL particles, the more carriers of cholesterol, and a greater risk for developing ASCVD. Lp(a) excess is the most commonly inherited lipid disorder in patients with premature coronary heart disease. Very high levels of Lp(a) are associated with elevated vascular risk. RLP is an atherogenic lipoprotein composed primarily of Very Low Density Lipoprotein (VLDL) and Intermediate Density Lipoprotein (IDL), and is believed to be a building block of plaque. Small, dense LDL are atherogenic particles that can easily penetrate the arterial endothelium and cause plaque formation. Approximately 50% of people who are at risk of heart disease are not identified by routine testing.the unique testing by BioReference Laboratories supports better identification and treatment of the growing population of individuals with or at risk for atherosclerotic cardiovascular disease (ASCVD) through four clinically relevant panels. The patient-friendly report allows for improved treatment management, and promotes patient compliance with their care. now includes a Lipoprotein Particle Evaluation that measures the lipoprotein subgroups, allowing healthcare providers to accurately determine and diagnose cardiovascular risk in patients. gives physicians the option of incorporating a Global Calculation using Framingham, Reynold s or Pooled Cohort to assess patient risk for atherosclerotic cardiovascular disease (ASCVD) events. Historical data listed on the report allow physicians to quickly reference previous results and more easily monitor patient progress. HEART HEALTH TESTING FROM GENPATH IS A COMPREHENSIVE APPROACH TO DIAGNOSING AND MANAGING PATIENTS WHO HAVE OR MAY BE AT RISK FOR HEART DISEASE. Markers HDL Cholesterol HDL Particle HDL2b Hemoglobin A1c hs-crp LDL Direct LDL Particle LP(a) Excess Remnant Lipoprotein (RLP) Small, dense LDL Relevance High Density Lipoprotein (HDL) slows arterial plaque buildup by transporting the cholesterol to the liver for disposal. The HDL particle number corresponds to the amount of bad cholesterol disposed by the liver. Therefore, the higher the number, the more cholesterol is disposed. Elevated levels of HDL2b and HDL3 are cardioprotective and are an indicator of how well excess lipids are removed from cells and transported back to the liver. Women tend to have higher levels than men. Reduced levels are associated with a risk of development of diabetes. Hemoglobin A1c (HbA1c) measures the average amount of sugar in your blood over a 3-month period and is used in the diagnosis and monitoring of diabetes. Diabetics are at an increased risk of ASCVD events. C-reactive protein (CRP) is an inflammatory protein; it is associated with inflammation of blood vessels and is associated with ASCVD, even in the absence of an elevated total cholesterol. Low Density Lipoprotein (LDL) can slowly build up in the inner walls of arteries, causing them to narrow. LDL particles transport cholesterol. The higher the number of LDL particles, the more carriers of cholesterol, and a greater risk for developing ASCVD. Lp(a) excess is the most commonly inherited lipid disorder in patients with premature coronary heart disease. Very high levels of Lp(a) are associated with elevated vascular risk. RLP is an atherogenic lipoprotein composed primarily of Very Low Density Lipoprotein (VLDL) and Intermediate Density Lipoprotein (IDL), and is believed to be a building block of plaque. Small, dense LDL are atherogenic particles that can easily penetrate the arterial endothelium and cause plaque formation. managing patients who have or may be at risk for atherosclerotic cardiovascular heart disease (ASCVD). Each of the four profiles now includes the new, which measures the four key components for accurate assessment of cardiovascular risk and treatment, as outlined by the National Cholesterol Education Program (NCEP). A Global Calculation using Reynolds, Framingham, or Pooled Cohort provides an estimated 10 year projection for ASCVD A Comprehensive Assessment that identifies at-risk patients potentially missed with traditional lipid testing The, which measures the lipoprotein subgroups including: VLDL Particles, Total LDL Particles, Non-HDL Particles, RLP - Remnant Lipoprotein, Small - Dense LDL III, Small - Dense LDL IV, Total HDL Particles, and Large - Buoyant HDL 2b A Full color report that features previous results, a new Assessment Graph, Therapeutic Guidelines, and patient-friendly results interpretations Profiles Components and Specimen Requirements Comprehensive CBC w/diff; CMP Baseline Profile Test Code F306-6 LP(a); hs-crp; HbA1c Baseline Profile Test Code Q471-5 LP(a); hs-crp; HbA1c Comprehensive CBC w/diff; CMP Monitoring Basic Lipid; LDL Direct Profile Test Code F307-4 hs-crp; HbA1c Monitoring Profile Test Code Q472-3 hs-crp; HbA1c NOTE: The Black and Yellow Top Lipotube is no longer a specimen requirement for the new profiles. Collateral Corner U. P. D. A. T. E. S A. N. D A. D. D. I. T. I. O. N. S ALL ITEMS WILL BE AVAILABLE FOR ORDER FOLLOWING THE TRAINING ON 10/29 UNLESS OTHERWISE NOTED. HEART HEALTH CLIENT ANNOUNCEMENT Will be sent automatically via fax to clients that have used in the past 90 days Will be sent automatically to clients that are ordering kit or requisition replenishment Will be featured as a pop-up splash page in CareEvolve ANNOUNCEMENT On Wednesday, October 28, 2015 BioReference Laboratories is pleased to announce the release of its enhanced Profiles, now including the new Lipoprotein Particle Evaluation to measure clinically relevant lipoprotein subgroups. BioReference Laboratories offers, a comprehensive approach to diagnosing and Our Portfolio Provides Clinically Relevant Advanced Lipid Testing, and includes: For questions related to these changes, or for additional information, please contact your sales representative. ITEM# HEART HEALTH PHYSICIAN SELL SHEET Outlines four Profiles as part of the Path to Better Care Portfolio Highlights of relevant markers tested within Profiles Includes specimen requirements The Path To Diagnosing Features include: Global Calculations Previous Results ITEM# The Path To Diagnosing Features include: Global Calculations Previous Results Laboratorio Buena Salud ITEM# ITEM# HEART HEALTH PATIENT BROCHURE Provides patient facing information regarding Outlines the importance of going beyond traditional lipid testing Your Path to Better Health Is Your y? Your Path to Better Health Is Your y? Laboratorio Buena Salud ITEM# ITEM# ITEM# 91737

6 l a r e r t lla rne o C Co U.P.D.A.T.E.S A.N.D A.D.D.I.T.I.O.N.S A L L I T E M S W I L L B E AV A I L A B L E F O R O R D E R F O L L OW I N G THE TRAINING ON 10/29 UNLESS OTHERWISE NOTED. HEART HEALTH SAMPLE REPORTS WITH FOUR PATIENTS RANGING FROM LOW TO HIGH RISK Relates to the sample patient scenarios included in the Physician Brochure Includes full sample reports for each scenario, with color results, assessment graph, therapeutic guidelines and patient interpretations pages Report Sample Type Clinical Women s Health Laboratorio Buena Salud FRANK/FRANCES (LOW RISK PATIENT): Item# Item# Item# JESSICA (LOW/MODERATE RISK PATIENT): Item# Item# Item# JOE/JOSEPHINE (MODERATE/HIGH RISK PATIENT): Item# Item# Item# MARIA (HIGH RISK PATIENT): Item# Item# Item# HEART HEALTH ATHEROSCLEROTIC PLAQUE FORMATION POSTER Provides visual of different particle types included in heart health Profiles Indicates how various particles relate to atherosclerotic plaque formation To be utilized as a patient education tool displayed in exam rooms Atherosclerotic Plaque Formation Atherosclerotic Plaque Formation VLDL Intima VLDL Intima LDL LDL Lumen Lumen HDL Atherosclerotic Plaque Build Up HDL Atherosclerotic Plaque Build Up Damaged Endothelium RLP Lp(a) RLP Lp(a) Oxidized LDL Dense LDL Laboratorio Buena Salud Damaged Endothelium Foam Cell facebook.com/ BioReferenceLaboratories twitter.com/ BioReference linkedin.com/ company/bioreference-laboratories 481 Edward H. Ross Drive, Elmwood Park, NJ tel fax BioReference Laboratories, Inc. All rights reserved /2015 ITEM# Oxidized LDL Dense LDL Foam Cell facebook.com/ GenPathWomensHealth twitter.com/ GenpathWH 481 Edward H. Ross Drive, Elmwood Park, NJ tel fax GenPath is a business unit of BioReference Laboratories BioReference Laboratories, Inc. All rights reserved /2015 ITEM# ITEM# HEART HEALTH LIPOPROTEIN PARTICLE EVALUATION PHYSICIAN BROCHURE Provides deep-dive into the new as part of the Profiles Highlights the importance of going beyond traditional lipid testing to accurately determine and diagnose cardiovascular risk in patients Includes four sample patient scenarios with risk ranging from low to high Outlines all of the Features and Benefits of the ures and Benefits Therapeutic Guidelines Clinical suggestions and therapeutic recommendations are included on each report. The NCEP guidelines provide dosage information on the various treatment options depending on circumstances. th traditional lipid testing g Lp(a), RLP, HDL2b and small, dense LDL groups of VLDL, LDL and HDL ts that are at risk for cardiovascular disease but have y patient s 10-year projection of ASCVD events rs and density (which directly correlates to size) d cholesterol-enriched patients oprotein particles before overt dyslipidemia of LDL, as a strong marker that may appear as a result protein assessment profile with subgroups and Available Nov 2 50 percent of people at risk for HEART DISEASE are not identified by routine testing References: 1. Chandra R, Macfarlane R. remnant lipoprotein density profiling by CsBiEDTA density gradient ultracentrifugation. Analytical Chemistry. 2006;78: Espinosa L, Macfarlane R, McNeal C. Method for lipoprotein(a) density profiling by BiEDTA differential density lipoprotein ultracentrifugation. Analytical Chemistry. 2006; 78: Nakajima K, Nakano T, Tanaka A. The oxidative modification hypothesis of atherosclerosis: The comparison of atherogenic effects on oxidized LDL and remant lipoproteins in plasma. Clin Chim Acta. 2006;367(1-2): Packard CJ. Small dense low-density lipoprotein and its role as an independent predictor of cardiovascular disease. Curr Opin Lipidol. 2006;17(4): rifugation, which is considered the CDC gold standard 5. Watanabe H, et al. Decreased high-density lipoprotein (HDL) particle size, prebeta-, and large HDL subspecies concentration in Finnish low-hdl families: Relationships with intima-media thickness. Aterioscler Thromb Vasc Biol. 2006;26(4): ary technology 6. Bell N, Johnson J, Donahoe E, Macfarlane R. Metal ion complexes of EDTA as solutes for density gradient ultracentrifugation: Influence of metal ions. Analytical Chemistry. 2005;77: entire lipoprotein density range 7. Capuzzi D, Carey C, Lincoff A, Morgan J. High-density lipoprotein subfractions and risk of Coronary Artery Disease. Current Atherosclerosis Reports. 2004;6: ml for accurate VLDL results acentrifugation at 120,000 rpm 8. Marcovina SM, Koschinsky ML. Evaluation of lipoprotein(a) as a prothrombotic factor: Progress from bench to bedside. Curr Opin Lipidol. 2003;14(4): Otvos J. Why cholesterol measurements may be misleading about lipoprotein levels and cardiovascular disease risk Clinical implications of lipoprotein quantification using NMR spectroscopy. J Lab Med. 2002;26(11/12): Cupples A, McNamara J, Nakajima K, Ordovas J, Schaefer E, Shah P, Wilson P. Remnant-like particle (RLP) cholesterol is an independent cardiovascular disease risk factor in women: Results from the Framingham Heart Study. Atherosclerosis. 2001;154(1): Handbook of Lipoprotein Testing, 2nd Edition, American Association for Clinical Chemistry, Inc., Washington DC, ndrome traits of results for patients s peutic recommendations on each report 12. Masuoka H, et al. Association of remnant-like particle cholesterol with coronary artery disease in patients with normal total cholesterol levels. Am Heart J. 2000;139(2): Laboratorio Buena Salud ITEM# ITEM# Seman L, et al. Lipoprotein(a)-cholesterol and coronary heart disease in the Framingham Heart Study. Clinical Chemistry. 1999;45: Cantin B, Dagenais G, Després J, Lamarche B, Moorjani S, Lupien P. Associations of HDL2 and HDL3 subfractions with ischemic heart disease in men. Prospective results from the Quebec Cardiovascular Study. Arterioscler Thromb Vasc Biol. 1997;17(6): Fortmann S, Gardner C, Krauss R. Association of small low-density lipoprotein particles with the incidence of coronary artery disease in men and women. JAMA. 1996; 276(11): Dahlen G. Lp(a) lipoprotein in cardiovascular disease. Atherosclerosis. 1994;108: The National Cholesterol Education Program (NCEP) 3rd Report of the Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (ATP III). National Heart Lung and Blood Institute, NIH Publication No , September Carlson LA, Hamsten A, Asplund A. Pronounced lowering of serum levels of lipoprotein Lp(a) in hyperlipidaemic subjects treated with nicotinic acid. J Intern Med Oct;226(4): Jacobson TA, Schein JR, Williamson A, Ballantyne CM. Maximizing the cost-effectiveness of lipid-lowering therapy. Arch Intern Med Oct 12;158(18): Bays H, Ezetimibe. Expert Opin Investig Drugs. 2002;11: n the path to treatment ances and Medicare GenPath Women s Health 481 Edward H. Ross Drive Elmwood Park, NJ t f Testing from BioReference Laboratories, featuring the, goes beyond traditional lipid testing to tell a more complete story 2015 BioReference Laboratories, Inc. All rights reserved /2015 ITEM# 92397