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The U.S. Food and Drug Administration has approved the use of a new test to determine
whether adults with severe coronary artery disease have high
cholesterol. Unlike a traditional blood test to measure cholesterol levels, the
"Cholesterol 1,2,3" test determines a patients cholesterol in the skin
using the palm of the hand. While the new test will not be routinely used on all patients,
the FDA said it can provide helpful information in patients who are already at high risk
of heart attack.
Heart disease is the leading cause of death in the United States and is a serious
worldwide problem. Approximately 12,800,000 Americans suffer from coronary artery disease,
and nearly 500,000 Americans die each year from heart attacks. Over 12 million Americans
have a history of heart attack, chest pain (angina), or both. Risk
factors for heart disease include high cholesterol, high blood pressure
(hypertension), smoking, obesity, diabetes (Type II, adult onset), and lack of physical
activity.
Typically, physicians monitor cholesterol by taking samples of a patients blood
and measuring the amount of LDL ("bad") cholesterol, HDL ("good")
cholesterol, and total cholesterol levels. According to the FDA, this standard method of
measuring cholesterol will not change for the majority of Americans. However, a new skin
cholesterol test will become available for patients will severe coronary artery disease,
in which 50% of two or more arteries are completely blocked, significantly increasing the
risk of heart attack. (A heart attack occurs when coronary artery is so severely blocked
that there is a significant reduction or break in the blood supply, causing damage or
death to a portion of the heart muscle).
The new skin cholesterol test, called Cholesterol 1,2,3, is made by Medical Innovations
Inc. of Toronto, Canada. The test consists of a band-aid-like applicator pad that is
placed on the palm of the hand. Drops of a special enzyme-containing liquid solution are
added to the pad, which remains on the palm for three minutes. The medical provider uses a
special handheld reader attached to a computer to read the amount of blue color in the
pad. The results are displayed on the computer screen, with a deeper blue signaling high
cholesterol.
Approximately 11% of cholesterol is found in the skin. Prior to approving the
Cholesterol 1,2,3 test, FDA officials analyzed clinical trial results, including a study
of 649 patients with a known degree of coronary artery blockages. In that trial, the skin
cholesterol test, when used with a standard blood cholesterol test, helped identify
patients with the most severe artery blockages. However, the test was administered mostly
on White patients between the ages 40 to 82. The FDA cautioned that because of this
limited pool, the test may be dependent on race and/or age.
While the overall favorable results on patients with severe heart disease led to FDA
approval of the skin cholesterol test, the test was not found to be effective at
identifying patients with less serious coronary artery disease. Thus, the test will not
become a standard screening tool for the general public.
According to Medical Innovations Inc., the skin cholesterol test should be around $10.
The company plans to begin selling Cholesterol 1,2,3 in Canada this summer. However, it is
unclear when the test will become available in the United States.
High cholesterol is a serious health problem in the United States. Recently, government
guidelines recommended a more aggressive approach for treating high cholesterol and
preventing heart disease in millions of women and men. In addition to more emphasis on
low-fat diets and exercise, the guidelines called for an increase in the number of people
that need to take cholesterol-lowering drugs from 13 million Americans to an estimated 36
million.
Cholesterol can be reduced by limiting consumption of saturated fats (whole-fat dairy
products, cheeses, red meats), increasing physical activity, and weight reduction when
appropriate. Increased consumption of monounsaturated fats (olive oil, nuts, fatty fish)
has been shown to reduce LDL cholesterol and increase HDL cholesterol, lowering heart
disease risk. Types of drugs commonly used to help lower cholesterol in patients include
statins, bile acid resins, nicotinic acid and fibrates.
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