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Cardiology

Low rates of lipoprotein(a) testing found

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Lipoprotein(a) testing remains infrequent, even among individuals with diagnosed cardiovascular disease (CVD), and the rates of testing have not significantly increased over the study period from 2012 to 2021, according to a study.

Despite the clinical significance of lipoprotein(a) in assessing CVD risk, it is underutilized in clinical practice.

The study assessed the prevalence of lipoprotein(a) testing in various CVD conditions and among individuals undergoing cardiac testing from 2012 to 2021.

The observational study collected information on unique lipoprotein(a) tests, CVD diagnoses (coded using ICD-10), and other cardiac tests. The research spanned a period during which 5,553,654 unique adults were evaluated, of which only 18,972 individuals (0.3%) underwent lipoprotein(a) testing.

Those who underwent lipoprotein(a) testing were more likely to be older, male, and of White ethnicity, often presenting with a greater burden of CVD. Specifically, lipoprotein(a) testing was conducted in 2.9% of individuals with ischemic heart disease (6469 cases), 3.1% with aortic stenosis (836 cases), 3.3% with a family history of CVD (4623 cases), 1.7% with stroke (1,202 cases), and 6.1% with coronary artery calcification (612 cases).

The prevalence of lipoprotein(a) testing in the same year as the diagnosis of CVD remained relatively stable over time, with a slight upward trend observed for most conditions., Lipoprotein(a) testing was performed in 1.8% of individuals (10,753 cases) who had lipid panels, with higher rates found in more specialized testing, such as coronary computed tomography angiography (6.8%) and apolipoprotein B (63.0%).

Reference

Bhatia HS, Hurst S, Desai P, et al. Lipoprotein(a) Testing Trends in a Large Academic Health System in the United States. J Am Heart Assoc. 2023 Sep 13:e031255. doi: 10.1161/JAHA.123.031255. Epub ahead of print. PMID: 37702041.

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