Lipoprotein(a) testing in lipid clinics across the UK: Results of a national survey.

• Lipoprotein(a) is an independent risk factor for cardiovascular disease and to understand the availability and application of Lp(a) measurement across UK lipid clinics, we undertook a national survey. • 60% of lipid clinics performed lipoprotein(a) testing once per patient and graded cardiovascular risk according to the lipoprotein(a) reference ranges recommended by HEART UK while cascade testing was performed on levels ≥200nmol/L. • Most lipid clinics reported lipoprotein(a) in mass units (mg/dL or mg/L) with no traceability to the WHO/IFCC reference material and only a third of lipid clinics used reagents that minimise sensitivity to the effect of lipoprotein(a) isoform size. • National effort is required to provide universal access to Lipoprotein(a) measurement and to harmonise the clinical application of this data. Lipoprotein(a) is an independent risk factor for cardiovascular disease and its use is recommended in national and international guidelines for cardiovascular disease risk stratification. We undertook a survey to understand the availability and application of lipoprotein(a) measurement across UK lipid clinics. Fifty-three out of an estimated 200 lipid clinics (27%) provided responses. Eighty-one percent of 53 clinics had access to lipoprotein(a) measurement. Twenty-seven clinics disclosed the number of lipoprotein(a) tests ordered annually with approximately half of the clinics (52%) requesting 0-250 tests per year. Sixty percent measured lipoprotein(a) once per patient and the leading indication was a personal or family history of premature history of cardiovascular disease in those <60 years old. Sixty-three percent of clinics that provided comments with lipoprotein(a) results graded cardiovascular risk as per the HEART UK consensus statement. Sixty percent of clinics performed family cascade testing on lipoprotein(a) results ≥200 nmol/L. Lipoprotein(a) was reported in nmol/L, mg/dL, or mg/L by 48%, 24%, and 28% of responding clinics, respectively. National effort is required to provide universal access to lipoprotein(a) measurement and to harmonise the clinical application of this data. [ABSTRACT FROM AUTHOR]