부산대학교 도서관

Introduction: There is consensus amongst major international societal guidelines including the AHA/ACC that elevated lipoprotein(a) [Lp(a)] > 50 mg/dL, present in 20% of the population, is a likely causal, independent, and hereditary risk factor for several cardiovascular (CVD) conditions. Despite its high prevalence, clinical measurement of Lp(a) has anecdotally been considered rare but has not been systematically quantified.Methods: We assessed the prevalence of Lp(a) testing for various CVD conditions across six academic medical centers associated with the University of California (UC), in total and by year from 2012-2021. Data from the UC data warehouse on unique CVD diagnoses using ICD codes, and unique Lp(a) testing for individuals with each diagnosis were collected. The proportion of individuals with a given CVD diagnosis and Lp(a) testing at any time during the study period or in the same year of their diagnosis was quantified. Finally, we evaluated the prevalence of elevated Lp(a) (>30 mg/dL and >50 mg/dL) for each diagnosis.Results: From 2012-2021, there were 18,830 unique Lp(a) tests. Lp(a) testing was performed in 6,855 individuals with ischemic heart disease (3.1%), 2,454 (3.4%) with MI, 1,157 (2.1%) with PVD, 1,261 (3.4%) with carotid stenosis, 1,250 (1.8%) with stroke, 908 (3.4%) with aortic stenosis, and 5,136 (3.6%) with a family history of CVD. For most conditions, the prevalence of testing in the same year as the diagnosis of CVD was relatively consistent over the study period, except for a progressive increase among those with MI (Figure). Across CVD diagnoses, the prevalence of Lp(a) >30mg/dL was 47.9 to 55.3% and for Lp(a) >50 mg/dL was 36.7 to 44.9%. The highest prevalence of elevated Lp(a) was among those with carotid stenosis, and the lowest was among those with family history of CVD.Conclusions: Lp(a) testing persists at low rates, even among those with diagnosed CVD, and remained stable over the study period except for MI.