Trends in testing and prevalence of elevated Lp(a) among patients with aortic valve stenosis

Lipoprotein(a) [Lp(a)] is causally associated with aortic valve stenosis (AS) but Lp(a) testing among AS patients is not broadly incorporated into clinical practice. We evaluated trends in Lp(a) testing in an academic medical center. Educational efforts and adding Lp(a) to the lipid panel on the ele...

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Bibliographic Details
Published in:Atherosclerosis 2022-05, Vol.349, p.144-150
Main Authors: Bhatia, Harpreet S., Ma, Gary S., Taleb, Adam, Wilkinson, Michael, Kahn, Andrew M., Cotter, Bruno, Yeang, Calvin, DeMaria, Anthony N., Patel, Mitul P., Mahmud, Ehtisham, Reeves, Ryan R., Tsimikas, Sotirios
Format: Article
Language:English
Subjects:
Aortic stenosis
Aortic Valve - surgery
Aortic Valve Stenosis - diagnosis
Aortic Valve Stenosis - epidemiology
Aortic Valve Stenosis - surgery
Heart Valve Prosthesis Implantation - methods
Humans
Lipids
Lipoprotein(a)
Prevalence
Risk Factors
Testing
Treatment Outcome
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Summary:Lipoprotein(a) [Lp(a)] is causally associated with aortic valve stenosis (AS) but Lp(a) testing among AS patients is not broadly incorporated into clinical practice. We evaluated trends in Lp(a) testing in an academic medical center. Educational efforts and adding Lp(a) to the lipid panel on the electronic medical record (EMR) and pre-procedure order sets were used to increase awareness of Lp(a) as a risk factor in AS. Medical records at University of California San Diego Health (UCSDH) were analyzed from 2010 to 2020 to define the yearly frequency of first time Lp(a) testing in patients with diagnosis codes for AS or undergoing transcatheter aortic valve replacement (TAVR). Lp(a) testing for any indication increased over 5-fold from 2010 to 2020. A total of 3808 patients had a diagnosis of AS and 417 patients had TAVR. Lp(a) levels >30 mg/dL were present in 37% of AS and 35% of TAVR patients. The rates of Lp(a) testing in AS and TAVR were 14.0% and 65.7%, respectively. In AS, Lp(a) testing increased over time from 8.5% in 2010, peaking at 24.2% in 2017, and declining to 13.9% in 2020 (p 
ISSN:0021-9150
1879-1484
DOI:10.1016/j.atherosclerosis.2022.01.022