This is a nicely-designed study. For decades, we've known that inflammation is a risk factor for heart attacks.

In this study, the researchers designed a custom antibody that binds to oral bacteria. Then they used histological staining to identify specific biofilm structures inside the atherosclerotic tissue. Bacteria released from the biofilm were observed in heart attack cases, which gives us evidence that when the body's immune system responded to these bacteria, it triggered inflammation which ruptured cholesterol-laden plaque. So now we have more insight into the mechanism behind why inflammation is associated with heart attack risk.

The "pantheon" of risk factors for heart disease are:

* hs-CRP (inflammation): the mechanism studied by this research. High inflammation roughly doubles your risk of heart disease.

* ApoB - 20% of people with normal cholesterol will have abnormal ApoB, and be at risk of heart disease (ApoB is a structural protein in lipoproteins which cause arterial plaque).

* Lp(a) - the strongest hereditary risk factor for heart disease (Lp(a) acts as a multiplier on ApoB, since it camouflages cholesterol particles from your liver)

* HbA1c - insulin resistance /diabetes is a risk factor for just about everything.

* eGFR - estimates the volume of liquid your kidneys can filter, and is an input to the latest heart disease risk models (PREVENT).

All of these risk factors can be measured with a blood test + doctor review. Easy to order online: https://www.empirical.health/product/comprehensive-health-pa...

You should probably disclose that the order link at the end of your post goes to your own company.

Basic LDL cholesterol and triglycerides blood panels are still an essential part of heart disease bloodwork, too.

I would suggest most people start by asking your doctor for some of these tests at your next annual checkup, as many of them and the doctor visit are likely covered by insurance. The ACA has special handling for routine annual checkups, so don’t assume it’s going to be expensive until you’ve checked the cost with your insurance. A routine bloodwork panel will also include a number of other important measures that are routine and very cheap. It’s helpful to have all of these on your medical record so trends can be identified over time.

IANAD, but

1) Isn't ApoB measurement pretty much in tandem with LDL, VLDL, and triglycerides? I realize it's being recognized now as the necessary factor for arterial dysfunction, but it seems like a lot of hoopla is being made as if it were some "silent" overlooked factor when for the vast, vast majority of people their ApoB levels are entirely explained by the other 3 lipid panel line items carrying it, and they have been in use for decades and are strongly targeted by the medical establishment

2) Isn't Lp(a) a separate lipoprotein altogether which is an independent risk factor for MACE? I've never heard of it "disguising" other cholesterol in testing.

For lipids, besides the named tests, HDL, LDL, and triglyceride tests are older but shouldn't be overlooked.

For measuring inflammation, besides hs-CRP, additional tests are relevant and overlooked: regular CRP, ESR, and homocysteine.

Additionally, a heart attack can result from parasite induced inflammation too, e.g. in chagas disease, which is becoming increasingly common in the US while being very undetected without explicit testing. It is also very difficult to treat, but the gist 4196f31d12a43a95756e792500ff516f has some info on treating it. Lyme disease too can harm the heart permanently. In both cases a pacemaker could help as applicable.

Understanding this is a shameless plug, it's very cool this exists.

The standard risk model based on SCORE-2 and PREVENT like parameters are very poor as reported in the recently published paper on the their accuracy performance by the Swedish team [1].

>All of these risk factors can be measured with a blood test + doctor review

As all CVD risk stratification with cardiologist review, the most important accuracy is sensivity (avoiding false negative that will escape review) of SCORE-2 and PREVENT, 48% and 26%, respectively [1].

The paper alternative proposal increased the sensitivity to 58% by performing clustering instead of conventional regression models as practiced in the standard SCORE-2 (Europe) and PREVENT (US).

These type of models including the latest proposal performed very poorly as indicated by their otherwise excellent and intuitive display of graphical abstract results [1].

[1] Risk stratification for cardiovascular disease: a comparative analysis of cluster analysis and traditional prediction models:

https://academic.oup.com/eurjpc/advance-article/doi/10.1093/...

For what it's worth, I did one of these sorts of heart health blood panels, which showed everything as fine except for hs-CRP which was something like 8x what it should be.

I took it to the doctor, doctor just shrugged it off and said it's probably fine and I might have just been fighting off a cold.

Is the fat rapture because the body wants fat to release vitamins and other stuff to help power itself to fight off the bacteria?

Do you happen to know how much that test costs? (Clicking a link to try to find out brought me to a page that asks for my zip code.)

What's the recommendation for someone with a hilariously high Lp(a)? Just pin LDL as low as possible?

So is poor oral hygiene a risk factor?

What do you do next if one is high? See your Doctor?

are you a cardiologist? Excellent points, thanks