Specialized Singulex blood

tests can help uncover hidden

cardiovascular disease risk
that other tests may miss.
Understanding your Singulex test results can help you
learn about the current state of your heart and blood
vessels, and how you can improve your cardiovascular
health. To make things clearer, the Singulex Clinical
Laboratory report color-codes results: green for
normal, yellow for some risk, and red for high
risk. If you have red or yellow results, you can take
action to change many of them.

Take action to improve

your heart health
You can significantly lower your risk for cardiovascular
disease by taking your medication as directed and by
making some new heart healthy lifestyle habits.

Live healthier
Risk
Categories
high

some

normal

Change your red and

yellow scores to green
over time

Improve your sleep quality

Choose heart-healthy foods and/or reduce portion size
Develop an activity routine that you enjoy, and stick with it
Reduce your stress as much as possible, and learn ways to
manage the stress you cant avoid
Take advantage of SingulexWellness, a personalized counseling and education
program that helps you improve your heart health by providing:
Access to Clinical Health Educators registered nurses who are experts in heart-healthy

nutrition, medication reminders, exercise, weight and stress management

Sample Test Report

Guidance and support in developing a personalized Wellness Action Plan that will help you

stick to your healthier lifestyle choices

INSURANCE COVERAGE
If a claim for your Singulex laboratory testing services is submitted to your
insurance company, you may receive a statement called an Explanation of
Benefits (EOB) from your insurer. The EOB documents the way in which your
claim was processed. The EOB is NOT a bill and you do not need to make
payment based upon the information it contains. You should, however, retain
a copy for your records.
Occasionally, your insurance company may issue a check
payment directly to you instead of Singulex. If you do
receive such a check, please sign the back of the check
and write Payable to Singulex. Please send the check
to our Billing Department, along with a copy of the EOB.

* Singulex Clinical Laboratory. Singulex proprietary lab developed tests were developed and performance characteristics
were determined by Singulex. These tests have not been cleared or approved by the U.S. Food and Drug Administration

2014 Singulex, Inc. Singulex, SgxHD, and SingulexWellness are trademarks or registered trademarks of Singulex, Inc.
97-0095-04

Singulex, Inc.
Attn: Billing Dept
Dept CH 19669
Palatine, IL 60055

Questions?
www.singulex.com
1.800.400.4344

Learn about Singulex tests and ways

to help improve heart health

Specialized blood
tests from Singulex
can play a key role
in your heart health
Each Singulex test measures a
different area of heart and blood
vessel health

FUNCTIONAL CARDIAC TESTS

These tests measure how well your
heart muscle is working
Cardiac Troponin-l* is released into the bloodstream
when your heart muscle is injured or stressed. This test is
able to find and measure small amounts of cardiac troponin,
potentially revealing early damage to the heart muscle that
can be repaired or sometimes reversed.
NT-proBNP (N-terminal pro b-type natriuretic peptide) is released
into the blood stream when heart muscle cells are overly
stretched because they are working too hard. High levels
of NT-proBNP may prompt your doctor to do additional
testing to determine the cause.
IMPROVEMENT SUGGESTIONS
Addressing the causes of damage or stress
to the heart, regular physical activity,
maintaining a heart healthy weight and
diet, improving sleep quality, drinking more
water and quitting smoking may improve
functional cardiac test results. Your doctor
can also recommend certain medications.

DYSLIPIDEMIA TESTS
These tests measure the size and
amount of fat and protein parts
(lipoproteins) in your blood, such
as cholesterol
LDL (low density lipoprotein) High LDL indicates that you
have too much bad cholesterol, which increases your risk
for cardiovascular disease (CVD).
HDL (high density lipoprotein) Low HDL indicates increased
risk because HDL (the good cholesterol) plays an important
role in carrying cholesterol out of arteries to the liver for
removal from the body.

*Singulex Clinical Laboratory. Singulex proprietary lab developed tests were developed
and performance characteristics were determined by Singulex. These tests have not been
cleared or approved by the U.S. Food and Drug Administration

INFLAMMATION TESTS
These tests show how
inflammation may be impacting
your blood vessel health

Inflammation is the bodys natural response

to injury or infection. However over time
inflammation may lead to cholesterol-rich
build-up (called plaque) in the arteries.
This build-up can block arteries and trigger
a heart attack or stroke, or cause other
problems in the body.
Endothelin* can cause blood vessels to tighten, which can
raise blood pressure. A high level may predict how far along
blood vessel disease has progressed, and may also be related to
chronic heart failure, kidney disease, sleep apnea, and diabetes.
Homocysteine High levels can be a risk marker for heart
disease. This can also mean that your vitamin levels of B12
and B6 are too low.

HDL2b* (high density lipoprotein 2b) is the largest of the HDL

particles and the most effective at carrying cholesterol out
of the arteries to the liver for removal. Low levels indicate
increased heart disease risk.
Lp(a)* [lipoprotein (a)] is an inherited cholesterol-carrying
particle. A high level is a big risk factor for heart disease.
Lifestyle changes usually do not affect Lp(a) levels, but
medications may be considered.
Triglycerides If you regularly eat more calories than
you burn or are eating a diet high in carbohydrates, your
triglycerides (a type of fat) can climb to unhealthy levels,
increasing your risk for heart disease and diabetes.
sdLDL* (small dense LDL) can enter artery walls more easily,
causing increased inflammation and heart disease risk.
High levels are common for those at risk for diabetes.

IL-6* (interleukin- 6), IL-17A* (interleukin- 17A),

and TNF-* (tumor necrosis factor- alpha) are released
into the bloodstream during the process of inflammation,
which may cause plaque build-up in the arteries. If left
untreated, this build-up can increase your risk of having
a heart attack or stroke.
Lp-PLA2 (lipoprotein-associated phospholipase A2) A high
result is a warning that inflammation and rupture-prone
plaque may be present in your arteries. Rupture-prone
plaque is more likely to break off in blood vessels, and is
a major cause of sudden heart attacks and strokes.
hs-CRP (high-sensitivity c-reactive protein) A high result
is another warning sign of inflammation in your body,
which may cause plaque build-up in your arteries,
increasing your risk of a heart attack or stroke.
IMPROVEMENT SUGGESTIONS
Considerations for improving inflammation
test results include maintaining a healthy
weight, regular physical activity, keeping
blood pressure within normal range,
managing stress and quitting smoking.
Discuss with your doctor if certain
medications may be right for you.

Apo B (apolipoprotein B) is found on the surface of LDL. High

levels have been shown to better predict increased heart
and blood vessel disease risk than LDL measurements alone.
Apo A1 (apolipoprotein A1) is found on the surface of HDL,
and is related to cholesterol removal. Therefore, a high level
of Apo A1 may help lower your heart disease risk.
IMPROVEMENT SUGGESTIONS
Lifestyle changes such as regular physical
activity, maintaining healthy weight,
limiting carbohydrates, sugar and alcohol,
and developing a heart healthy diet may
help lower levels of dyslipidemia results.
Your doctor can also discuss certain
medications or supplements that may help.

*Singulex Clinical Laboratory. Singulex proprietary lab developed tests were developed
and performance characteristics were determined by Singulex. These tests have not been
cleared or approved by the U.S. Food and Drug Administration

CARDIOMETABOLIC TESTS
These tests assess your risk for
developing type 2 diabetes and
heart disease. Managing diabetes
and pre-diabetes is critical for
maintaining heart health

Adiponectin* is a heart-protective hormone that may

help fight inflammation. Low levels are related to obesity
(especially abdominal fat), increased inflammation, heart
disease, and type 2 diabetes.
Leptin* is a hormone that regulates normal appetite
and energy use. High levels can indicate an increased
risk of type 2 diabetes and heart disease. Maintaining a
high-protein/low-carbohydrate diet may lower levels.
Cortisol is a hormone that controls blood sugar,
inflammation, and immune response. Constant stress
can lead to regularly high levels, increasing risk for
type 2 diabetes and heart disease. Getting more sleep,
reducing stress and addressing sleep apnea may help
lower cortisol levels.
Ferritin High levels can mean too much iron in the body,
which can contribute to inflammation and increased risk
for heart disease and type 2 diabetes. This condition can
be improved by reducing consumption of red meat and
iron-fortified foods or vitamins (cereals, energy bars, etc.).
Glucose A high glucose (blood sugar) level can mean
there is significant risk of type 2 diabetes and heart disease.
HbA1c (hemoglobin A1c) measures average blood sugar over
the past 3 months. An elevated HbA1c may prompt your
doctor to do more tests for type 2 diabetes.
Cystatin C High levels of Cystatin C are an early sign of
kidney problems, as well as a risk factor for heart disease,
heart attack, and stroke. Medications may be prescribed
and blood pressure control suggested to lower levels.
Insulin is a hormone that controls the level of glucose in
your blood. Elevated fasting insulin levels may mean that
your body is having a difficult time controlling your blood
sugar, which can put you at increased risk for type 2 diabetes
and heart disease.

Vitamin D Low levels of Vitamin D, or Vitamin D

deficiency, can occur in people who are obese or have
dark skin, as well as those with poor diets or limited
exposure to the sun. This deficiency decreases the bodys
ability to process calcium and increases inflammation,
which can contribute to high blood pressure, and increase
the risk of heart attack, heart failure, and low bone density.
Safe sun exposure, a diet high in vitamin D, and supplements may help Vitamin D levels.
PTH (parathyroid hormone) High PTH levels are most often
seen with kidney disease and/or low vitamin D levels, and
are related to increased risk for type 2 diabetes, heart
disease, and heart disease-related death. Considerations
should address the cause of increased PTH, which can
mean treating low vitamin D.
TSH (thyroid stimulating hormone), T3/Free T3 (triiodothyronine),
T4/Free T4 (thyroxine) Abnormal values of these thyroid
tests can mean that there are changes in cholesterol and
protein digestion that can lead to increased heart disease
risk. Medications may help balance the hormones.
Uric Acid High levels of uric acid increase heart disease
risk, and can be caused by kidneys not getting rid of waste
efficiently, or by a purine-heavy diet (purines are found in
some meats, seafood and alcohol and form uric acid when
broken down in the body). Lowering dietary purines or
taking medications may help lower uric acid levels.
Testosterone Low testosterone in men is related to
increases in abdominal fat, blood pressure and cholesterol,
all factors involved in increasing heart disease risk. The
opposite is true in women, for whom high testosterone
levels may be related to increased heart disease risk.
SHBG (sex hormone binding globulin) is a protein that attaches
to testosterone and turns it off. Measuring the unattached
testosterone that is active allows physicians to initiate and
monitor appropriate therapy.
IMPROVEMENT SUGGESTIONS
Considerations for improving cardiometabolic test results include weight
management, regular physical activity,
a heart healthy diet, quitting smoking
and in some cases a low-carbohydrate
diet. Discuss with your doctor if certain
medications my be right for you.

*Singulex Clinical Laboratory. Singulex proprietary lab developed tests were developed
and performance characteristics were determined by Singulex. These tests have not been
cleared or approved by the U.S. Food and Drug Administration