Cardiovascular risk, the full read
Boston Heart Cardio Advanced.
Lipoprotein subfractions, oxidation, inflammation, insulin resistance, and the genetic markers that shape your statin response. The cardiovascular panel for the question standard lipids cannot answer.
By Boston Heart Diagnostics · Fasting venous blood draw
Why it matters
About half of first heart attacks happen in people with "normal" cholesterol on a standard panel. Total cholesterol and LDL-C miss the markers that actually drive plaque biology: the count of atherogenic particles (apoB), the genetic Lp(a), the oxidized LDL that the immune system goes after, and the inflammation markers that tell you what state the artery wall is in. The Boston Heart panel reads the whole picture so the conversation about statins, ezetimibe, PCSK9 inhibitors, and lifestyle is built on the real risk.
Lp(a) is genetic and measured once in a lifetime. About 20% of the population has clinically elevated Lp(a), and most do not know it. Standard panels do not include this marker. Boston Heart does, and the result reshapes how aggressively the rest of the risk needs to be managed.
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What I read for
I read the Boston Heart panel against optimal physiology, not against population means. The standard lipid panel gives you a few numbers; this panel gives you the lipoprotein particle network, the inflammatory state of the vessel wall, the insulin resistance underneath, and the genetic context that predicts which statins work for your biology.
- ApoB. The count of every atherogenic particle in your bloodstream. The marker that actually drives treatment decisions.
- Lp(a). Genetic, measured once. About 20% of patients have clinically elevated Lp(a) and do not know it.
- LDL particle number and size pattern A vs pattern B. Small dense LDL drives risk that LDL-C alone does not capture.
- Oxidized LDL and MPO. The vessel-wall inflammation read, which often moves earlier than the lipid numbers do.
- Insulin resistance markers (fasting insulin, HOMA-IR, adiponectin). The metabolic driver underneath most adult cardiovascular disease.
- Statin response genetics (KIF6, ApoE genotype). Which statins your biology actually responds to.
What it measures
Boston Heart Cardio Advanced reads the full lipoprotein network, the inflammation markers, the insulin and adiposity context, and the genetic factors that shape pharmacological risk reduction. It is the cardiac panel for the question a standard lipid panel cannot answer.
See all 32 biomarkers
Standard lipid panel (for completeness)
- Total cholesterol
- LDL cholesterol (LDL-C)
- HDL cholesterol (HDL-C)
- Triglycerides
- Non-HDL cholesterol
Lipoprotein subfractions
- ApoB (atherogenic particle count)
- ApoA1 (HDL particle count)
- ApoB/ApoA1 ratio
- LDL particle number (LDL-P)
- LDL particle size pattern (A vs B)
- Small dense LDL
- HDL2 and HDL3 subfractions
- Lp(a) [measured once, lifetime marker]
- VLDL subfractions
Oxidation and inflammation
- Oxidized LDL
- Myeloperoxidase (MPO)
- Lp-PLA2 activity
- hs-CRP
- Fibrinogen
Insulin resistance and metabolic context
- Fasting insulin
- Fasting glucose
- HOMA-IR (calculated)
- HbA1c
- Adiponectin
Cardiometabolic genetics
- ApoE genotype (e2/e3/e4)
- KIF6 polymorphism (statin response)
- 9p21 polymorphism (CAD risk)
Nutritional and homocysteine context
- Homocysteine
- Vitamin D (25-OH)
- Omega-3 index (when added)
- Vitamin B12
- Folate
Who this is for
The Boston Heart panel earns its place when the cardiovascular question is too big for a standard lipid panel to answer.
Common reasons I order it
- Anyone with a family history of heart attack, stroke, or early coronary disease.
- Patients whose standard lipid panel looks normal but who have other risk signals (high CAC score, elevated fasting insulin, abdominal obesity, family history).
- Patients with elevated LDL-C considering whether and which statin to start.
- Statin-intolerant patients (myalgia, side effects) where genetic statin-response data could redirect to a different molecule.
- Patients optimizing already (low LDL, exercising, weight controlled) who want to know what residual risk looks like at the lipoprotein particle and vessel-wall inflammation level.
Not for everyone. When a basic lipid panel and a coronary calcium score answer the question, that is the right combination.
How collection works
- 1
Lab requisition issued
After your intake, I order the Boston Heart panel through the practice. You get a requisition by email.
- 2
Fasting blood draw at a local Quest or LabCorp
Most Boston Heart panels are run through Quest or LabCorp draw stations. The draw is standard fasting venous blood, takes about 10 minutes, and the lab sends the sample to Boston Heart Diagnostics for processing.
- 3
Results in about 14 days
From the day Boston Heart receives the sample. You get the raw Boston Heart report plus a written interpretation specific to your case.
How to prepare
Boston Heart requires standard cardiac-panel prep. The window is the morning of the draw; the rest of the panel is robust to normal life.
Diet and timing
Fast 10-12 hours before the draw: Water and prescribed medications are fine. No food, no caloric drinks. Black coffee is debated; for this panel, skip it to avoid affecting triglycerides.
Avoid alcohol 24-48 hours before: Alcohol raises triglycerides and shifts HDL subfractions enough to confuse the read.
Maintain your normal diet otherwise: Do not low-carb-load or keto-prep before the draw. The panel needs to reflect your normal physiology, not a one-day intervention.
Supplements and medications
Take prescribed cardiac medications normally: Statins, ezetimibe, PCSK9 inhibitors, antihypertensives. The panel reads your physiology on the regimen you are actually on.
Hold high-dose biotin for 48 hours: Biotin interferes with some Boston Heart assays. Skip the day before and the day of.
Hold fish oil 24 hours before (optional): If we are reading the omega-3 index, the day-before supplement shifts the result. For routine reads, normal supplementation is fine.
What you get
The full Boston Heart Cardio Advanced report (lipoprotein network, oxidation, inflammation, insulin resistance, cardiometabolic genetics, nutritional context).
A written interpretation from Dr. Tagge, specific to your case, with the apoB and Lp(a) read called out and a clear treatment-direction summary.
A 30-minute video review to walk through the panel and what the next move is.
Questions
A standard panel reports total cholesterol, LDL-C, HDL-C, and triglycerides. Those four numbers miss the markers that actually drive plaque biology: apoB (atherogenic particle count), Lp(a) (genetic), small dense LDL, oxidized LDL, vessel-wall inflammation markers, and the insulin resistance underneath. The Boston Heart panel reads all of that. The interpretation focuses on the markers that change treatment decisions, not the ones that change because of fasting.
Often yes. The statin lowers LDL-C, but it does not change Lp(a), it does not measure residual particle count well, and it does not tell you whether the vessel wall is still inflamed. The Boston Heart panel reads whether your current regimen is doing the work, or whether the residual risk warrants adding ezetimibe, a PCSK9 inhibitor, or lifestyle intensification.
Some markers are covered (standard lipids, hs-CRP, HbA1c) depending on diagnosis codes. The lipoprotein subfractions and genetic markers are typically cash-pay through the practice. Boston Heart provides CPT codes for possible reimbursement.
About 14 days from when Boston Heart receives the sample. The draw itself is fast; the genetic-marker turnaround drives the timeline.
Available standalone
Requisition issued within 2 business days. Your written interpretation arrives within 7 business days of the lab releasing results.
From the writing