リポタンパク質(a)の臨床医による認識、検査、および治療：米国の大規模全国調査の結果

Data are limited regarding national clinician awareness, testing, and treatment of lipoprotein(a) [Lp(a)]. We conducted a national survey of US clinicians to investigate these issues.

An internet-based survey of awareness, testing and treatment of Lp(a) was administered by a medical survey company to clinicians who have been in practice ≥5 years in the US or its territories.

2002 clinicians completed the survey: 47 % were primary care, 35 % cardiology, 9 % endocrinology, and 9 % neurology. 28 % were female, 24 % Asian, 4 % Hispanic, and 3 % Black. Awareness: 81 % of respondents agreed Lp(a) is a significant risk driver for cardiovascular disease (CVD). 77 % and 75 % agreed knowing Lp(a) would help in risk stratification and increase patient engagement, respectively. Testing: 41 % of respondents agreed with universal testing of Lp(a). Most agreed Lp(a) should be measured in those with premature (73 %), family history of premature (71 %), or recurrent CVD events (68 %). Treatment: 77 % reported having CVD outcome data were felt to be very important for a new therapy, followed by long-term efficacy/safety data (69 %), real-world data (53 %), magnitude of Lp(a) reduction (21 %), dosing frequency (17 %), and mechanism of action (12 %). Clinicians reported being most likely to consider prescribing Lp(a)-targeted therapy with proven CVD benefit among patients with premature (47 %) or recurrent (51 %) CVD events.

Most clinicians agree knowing the Lp(a) level can improve risk assessment and patient engagement. Patients with premature or recurrent CVD events are most likely to be targeted for Lp(a) testing and for prescribing possible future Lp(a)-targeted therapies.