Highlights
- •Lp(a) tests are rarely performed even in patients with high cardiovascular risk.
- •Lp(a) testing is associated with more intensive treatment and lower mortality.
- •Lp(a) testing is an opportunity to improve ASCVD prevention.
Abstract
Background and aims
Lipoprotein(a) (Lp(a)) is associated with an increased risk of atherosclerotic cardiovascular
disease (ASCVD). Our goal was to characterize patients undergoing Lp(a) testing and
to assess the impact of Lp(a) testing on treatment changes and subsequent ASCVD events.
Methods
A cross-sectional and a longitudinal claims data analysis was performed on 4 million
patient records in Germany. Patients were followed up for a maximum of 4 years.
Results
In 2015 and 2018, 0.25% and 0.34% of patients were tested, respectively. Testing was
more frequent in younger women in the overall population, and in men in the ASCVD
population. Patients tested for Lp(a) had more comorbidities and higher ASCVD risk
compared to matched control patients. ASCVD hospitalizations were more frequent prior
to the first Lp(a) test (5.55 vs 1.42 per 100/person-years). The mortality rate of the Lp(a)-tested cohort and the
control group was similar. Mortality was lower in patients with prior ASCVD and Lp(a)
testing compared to matched controls with prior ASCVD and no Lp(a) test (2.30 vs 3.64 per 100/person-years, p <0.001). Patients with Lp(a) test received more laboratory examinations and cardiovascular
medications and had more visits with specialized physicians.
Conclusions
Lp(a) testing is rarely performed even in patients with very high cardiovascular risk.
Patients tested for Lp(a) have more comorbidities and a higher ASCVD risk. Lp(a) testing
is associated with more intensive preventive treatment and with positive effects on
clinical outcomes and survival. The data support the value of Lp(a) measurements to
characterize ASCVD risk and to improve ASCVD prevention.
Graphical abstract
Graphical Abstract
Keywords
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Article info
Publication history
Accepted:
January 18,
2023
Received in revised form:
January 9,
2023
Received:
October 26,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Published by Elsevier B.V.
