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Prevalence of Lipoprotein(a) Testing in Patients With Atherosclerotic Cardiovascular Disease Within a Large

David Eccleston1, Enayet K Chowdhury1, Anna Williamson2

  • 1Advara HeartCare, Data and Research, Paddington, Qld, Australia.

Heart, Lung & Circulation
|April 22, 2026
PubMed

Insights

Lipoprotein(a) (Lp[a]) testing remains underutilized in Australian patients with atherosclerotic cardiovascular disease (ASCVD). Increased Lp[a] testing is crucial for managing ASCVD risk factors and improving patient outcomes.

Area of Science:

  • Cardiology
  • Clinical Biochemistry
  • Public Health

Background:

  • Elevated lipoprotein(a) (Lp[a]) is a significant genetically determined risk factor for atherosclerotic cardiovascular disease (ASCVD).
  • Historically, Lp(a) testing has been infrequent in Australia, despite its clinical importance.
  • This study investigates the prevalence, trends, and patient characteristics associated with Lp(a) testing in Australia.

Purpose of the Study:

  • To assess the current prevalence of Lp(a) testing among patients with ASCVD in Australia.
  • To analyze trends in Lp(a) testing rates over time.
  • To identify patient demographics and comorbidities associated with Lp(a) testing.

Main Methods:

  • Retrospective cross-sectional study utilizing over 1.1 million de-identified electronic medical records from 2011 to 2022.
  • Natural language processing algorithm to identify patients with ASCVD and Lp(a) testing, extracting relevant clinical data.
  • Analysis of historical (2011-2021) and baseline (2022) cohorts, with 18-month follow-up for the baseline group.

Main Results:

  • Lp(a) testing increased from 0.9% in the historical cohort to 2.6% in the baseline cohort among patients with ASCVD.
  • In the baseline cohort, 30.2% had Lp(a) levels ≥70 mg/dL, and 86.8% were on lipid-lowering therapy.
  • Dyslipidaemia (72.8%) and Stage 1-2 chronic kidney disease (40.1%) were the most common comorbidities.

Conclusions:

  • Lp(a) testing is significantly underutilized in Australian ASCVD patients, contrary to recent guideline recommendations.
  • There is a clear need to increase Lp(a) testing to better identify and manage high-risk cardiovascular patients.
  • Expanding Lp(a) testing can lead to improved health outcomes for individuals at risk of ASCVD.
Abstract

Keywords:
ASCVDArtificial intelligenceElectronic medical recordLipoprotein(a)

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