Lipoprotein(a) testing and levels among patients with atherosclerotic cardiovascular disease: a large single-centre experience from the United Arab Emirates - Scorecard - MDSpire
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Lipoprotein(a) testing and levels among patients with atherosclerotic cardiovascular disease: a large single-centre experience from the United Arab Emirates
Clinical Scorecard: Assessment of Lipoprotein(a) Levels in Atherosclerotic Cardiovascular Disease Patients: Insights from a Major Single-Center Study in the United Arab Emirates
At a Glance
Category
Detail
Condition
Atherosclerotic cardiovascular disease (ASCVD) with elevated lipoprotein(a) (Lp(a)) levels
Key Mechanisms
Elevated Lp(a) is linked to higher risk of cardiovascular events and may identify patients needing intensified lipid-lowering therapies
Target Population
Adult patients (≥18 years) with ASCVD including coronary artery disease, ischemic stroke, or peripheral artery disease
Care Setting
Single tertiary care center in the United Arab Emirates, including cardiology, neurology, endocrinology clinics, and preventive medicine programs
Key Highlights
Only 5.5% of ASCVD patients had Lp(a) tested, with higher testing rates (7%) in premature ASCVD patients.
20.9% of tested patients had elevated Lp(a) levels (>125 nmol/L), with higher median levels in premature ASCVD.
Patients with higher Lp(a) percentiles were more likely to have hyperlipidaemia, diabetes, heart failure, premature ASCVD, and receive PCSK9 inhibitors and ezetimibe.
Guideline-Based Recommendations
Diagnosis
ESC/EAS recommends Lp(a) testing at least once in every adult's lifetime.
Measure Lp(a) in patients with personal or family history of premature ASCVD.
Repeat Lp(a) testing in ASCVD patients with borderline levels (~75–125 nmol/L).
Management
Intensify lipid-lowering therapies in patients with elevated Lp(a).
Consider PCSK9 inhibitors and ezetimibe in patients with high Lp(a) levels.
Monitoring & Follow-up
Close monitoring and repeat Lp(a) testing in patients with borderline elevated levels.
Risks
Elevated Lp(a) is associated with increased risk of cardiovascular events and premature ASCVD.
Patient & Prescribing Data
Patients with ASCVD undergoing Lp(a) testing, including those with premature ASCVD
Higher Lp(a) levels correlated with increased use of PCSK9 inhibitors (16.1% vs 1.3%) and ezetimibe (18.8% vs 9.4%) within 3 months post-testing
Clinical Best Practices
Incorporate Lp(a) testing in ASCVD patients, especially those with premature disease or family history.
Use Lp(a) levels to guide intensification of lipid-lowering therapies including PCSK9 inhibitors and ezetimibe.
Increase awareness and utilization of Lp(a) testing in secondary prevention populations.
Monitor patients with borderline Lp(a) levels with repeat testing to guide management.
