Related Experiment Video
Updated: Jul 16, 2025
Antibody Profiling by Luciferase Immunoprecipitation Systems LIPS
Published on: October 7, 2009
Lipoprotein(a) Testing Trends in a Large Academic Health System in the United States
Harpreet S Bhatia1, Samantha Hurst2, Paresh Desai3
1Division of Cardiology, Department of Medicine University of California San Diego La Jolla CA.
Insights
Lipoprotein(a) testing remains uncommon, even for patients with cardiovascular disease (CVD). This study found low and stable testing rates from 2012-2021 across six University of California medical centers.
Area of Science:
- Cardiovascular Medicine
- Clinical Diagnostics
- Epidemiology
Background:
- Lipoprotein(a) is a significant cardiovascular risk factor, yet its clinical measurement is infrequent.
- Systematic quantification of lipoprotein(a) testing prevalence has been lacking.
- Understanding testing patterns is crucial for improving cardiovascular risk assessment.
Purpose of the Study:
- To assess the prevalence of lipoprotein(a) testing.
- To analyze testing rates across different cardiovascular disease (CVD) conditions.
- To evaluate testing trends in relation to cardiac diagnostic procedures.
Main Methods:
- Observational study utilizing data from the University of California Health Data Warehouse (2012-2021).
- Collected data on unique individuals undergoing lipoprotein(a) testing, CVD diagnoses (ICD-10 codes), and other cardiac testing.
- Calculated the proportion of individuals tested for lipoprotein(a) overall, by CVD diagnosis, and by cardiac test.
Main Results:
- Out of 5,553,654 adults, only 18,972 (0.3%) had lipoprotein(a) testing.
- Testing rates were higher in individuals with ischemic heart disease (2.9%), aortic stenosis (3.1%), family history of CVD (3.3%), stroke (1.7%), and coronary artery calcification (6.1%).
- Lipoprotein(a) testing was more common with specialized cardiac tests like coronary CT angiography (6.8%) and apolipoprotein B testing (63.0%).
Conclusions:
- Lipoprotein(a) testing rates remain low, even in patients with diagnosed cardiovascular disease.
- Testing prevalence showed a slight upward trend but remained relatively stable over the decade.
- Current testing practices may not fully align with the clinical significance of lipoprotein(a) in CVD risk stratification.
Abstract:
Background Despite its high prevalence and clinical significance, clinical measurement of lipoprotein(a) is rare but has not been systematically quantified. We assessed the prevalence of lipoprotein(a) testing overall, in those with various cardiovascular disease (CVD) conditions and in those undergoing cardiac testing across 6 academic medical centers associated with the University of California, in total and by year from 2012 to 2021. Methods and Results In this observational study, data from the University of California Health Data Warehouse on the number of individuals with unique lipoprotein(a) testing, unique CVD diagnoses (using International Classification of Diseases, Tenth Revision [ICD-10], codes), and other unique cardiac testing were collected. The proportion of total individuals, the proportion of individuals with a given CVD diagnosis, and the proportion of individuals with a given cardiac test and lipoprotein(a) testing any time during the study period were calculated. From 2012 to 2021, there were 5 553 654 unique adults evaluated in the University of California health system, of whom 18 972 (0.3%) had lipoprotein(a) testing. In general, those with lipoprotein(a) testing were more likely to be older, men, and White race, with a greater burden of CVD. Lipoprotein(a) testing was performed in 6469 individuals with ischemic heart disease (2.9%), 836 with aortic stenosis (3.1%), 4623 with family history of CVD (3.3%), 1202 with stroke (1.7%), and 612 with coronary artery calcification (6.1%). For most conditions, the prevalence of testing in the same year as the diagnosis of CVD was relatively stable, with a small upward trend over time. Lipoprotein(a) testing was performed in 10 753 individuals (1.8%) who had lipid panels, with higher rates with more specialized testing, including coronary computed tomography angiography (6.8%) and apolipoprotein B (63.0%). Conclusions Lipoprotein(a) testing persists at low rates, even among those with diagnosed CVD, and remained relatively stable over the study period.
