Medical Policy Lipoprotein Subclass Testing in the evaluation of Cardiovascular disease

Overview: Lipoproteins are spherical particles that carry lipids, particularly cholesterol and triglyceride, in the plasma. There is a well-established association between dyslipidemias, or disorders of lipoprotein metabolism, and coronary heart disease (CHD): elevated levels of blood cholesterol, especially low-density lipoprotein cholesterol (LDL-C), and low levels of high-density lipoprotein cholesterol (HDL-C) increase risk for CHD. The relationship between triglyceride levels and CHD is controversial, although it is known that some triglyceride-rich lipoproteins can be atherogenic. Examination of HDL subclasses could contribute to an improved understanding of the dynamic interaction between HDL-C metabolism and CHD