A complete cholesterol screening includes the following tests:

• Total cholesterol (or total serum cholesterol). This test calculates the total amount of cholesterol in the blood. The total cholesterol level equals HDLs + LDLs + 1/5 triglycerides.
  
  
• Triglycerides test. This test measures the amount of triglycerides present in the blood.
  
  
• Lipoprotein/cholesterol fractionation. This test determines the specific amounts of HDL and LDL found in the blood using ultracentrifugation (a process by which particles of different weights are separated out by spinning them at high speed in a centrifuge).
  
  
• Cholesterol ratio. This ratio is derived by dividing the total cholesterol by the HDL level. According to the American Heart Association, the level of total cholesterol should not be more than five times the level of HDLs (a ratio of 5:1).
  
  
• Apolipoprotein testing. This test measures two types of apolipoproteins: Apolipoprotein B100 (Apo-B) and Apolipoprotein CII (Apo-C-II). Recent studies indicate that Apo-B levels are a better indicator of coronary artery disease risk in women than traditional cholesterol test measures. This may be because HDL and LDL levels are indirect measurements, whereas Apo-B can be measured directly.
  
  
• Lipoprotein phenotyping. This test is a specific analysis of four lipoprotein substances in the blood: chylomicrons, HDLs, LDLs and very low-density lipoproteins  (VLDL). An excess of lipoproteins (hyperlipoproteinemia) is far more common than a shortage of lipoproteins (hypolipoproteinemia), the former condition has been classified into six categories: I, IIa, IIb, III, IV and V. Phenotyping places patients into one of these risk categories and help the physician to determine a course of treatment.

When performing cholesterol tests for screening purposes, usually only the total cholesterol test will be used. If results of that test are higher than desired, physicians may order triglyceride or lipoprotein/cholesterol fractionation tests to better evaluate treatment options. Lipoprotein phenotyping is generally used only in cases of hyperlipoproteinemia.

In some cases, a C-reactive protein test will be performed in addition to a cholesterol test. C-reactive protein (CRP) is a substance produced by the liver that increases whenever there is inflammation somewhere in the body. Until recently, CRP was the only inflammatory marker found to be an indicator of heart health. Therefore, a CRP test was often performed to help predict a patient’s risk of heart attack.

Researchers are also studying other proteins and inflammatory markers to see if they may better predict the risk of heart attack. One of these, placental growth factor protein (PIGF), is a protein released from cells specifically within blood vessels in response to inflammation. PIGF occurs in both men and women, and its discovery may also lead to new treatment methods.