Lipoprotein(a) testing in clinical practice: real-life data from a large health-care provider
| العنوان: | Lipoprotein(a) testing in clinical practice: real-life data from a large health-care provider |
|---|---|
| المؤلفون: | B Zafrir, A Aker, W Saliba |
| المصدر: | European Heart Journal. 43 |
| بيانات النشر: | Oxford University Press (OUP), 2022. |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | Cardiology and Cardiovascular Medicine |
| الوصف: | Background Evidence support a causal role of lipoprotein(a) [Lp(a)] in the development of atherosclerotic cardiovascular disease (ASCVD). Novel treatment options are emerging and recent guidelines recommend screening Lp(a) levels at least once during lifetime. However, significant variance exists regarding the incorporation of Lp(a) into patient care. Purpose To investigate patterns of Lp(a) measurement in a large health maintenance organization (HMO) and describe clinical characteristics associated with elevated Lp(a) levels. Methods Retrospective analysis of all Lp(a) laboratory tests performed between January 2015 and December 2021 in a single HMO providing health care for approximately 4.6 million insured members. Results Overall, 4,539 individuals were tested for Lp(a). Analysis was limited to the adult population (n=3900). Number of persons tested yearly increased progressively from 89 in the year 2015 to 1523 in 2021. Mean age was 55±15 years (39% females), 15% had family history of coronary disease, 40% ischemic heart disease, 7% prior stroke and 9% peripheral artery disease (PAD). Baseline low-density lipoprotein cholesterol (LDL-C) >190 mg/dl was evident in 21% of patients. Lp(a) level >125 nmol/l (∼50 mg/dl) was noted in 21.5%. In a multivariable logistic regression model, prior myocardial infarction (odds ratio 1.38, 95% confidence interval 1.16–1.64), PAD (1.29, 1–1.68), peak LDL-C>190 mg/dl (1.35, 1.12–1.62) and use of statins (1.54, 1.28–1.85), were independently associated with elevated Lp(a) levels >125 nmol/l, whereas an inverse association was seen with obesity (0.74, 0.62–0.88). Of the patients with elevated Lp(a), 72.4% were treated with statin and/or ezetimibe and 1.9% with PCSK9 inhibitors. Conclusions The reporting of Lp(a) levels is increasing, though it is still measured in a small portion of the population. Presence of ASCVD and severe hyperlipidemia may identify patients that should be considered for screening for increased Lp(a) levels. The use of PCSK9 inhibitors in those with elevated Lp(a) is yet considerably low. Funding Acknowledgement Type of funding sources: None. |
| تدمد: | 1522-9645 0195-668X |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_________::d3296876031edf149f311dfd89773ec1 https://doi.org/10.1093/eurheartj/ehac544.2341 |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi...........d3296876031edf149f311dfd89773ec1 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15229645 0195668X |
|---|