Lipoprotein test could save people from cardiovascular disease

Routine testing for a specific lipoprotein known as Lp(a) would be a cost-saving way to significantly reduce the risk of cardiovascular disease and save lives, according to an international taskforce led by Monash University.

Elevated levels of Lp(a) impact an estimated one in five people worldwide and lead to an increased risk of cardiovascular disease, the number one cause of death globally. Despite this, levels of Lp(a) are not routinely measured in clinical practice and most people with elevated levels don’t know they’re at risk.

A new study from the Lp(a) International Taskforce, established by the FH Europe Foundation (FHEF), analysed data from over 10,000 adults in the UK. The results, published in the journal Atherosclerosis, found that routine Lp(a) testing would have reclassified 20% of participants as high risk, leading to earlier intervention with blood pressure or cholesterol-lowering medications.

“Elevated Lp(a) is an inherited, lifelong and independent risk factor for heart attacks, strokes, aortic stenosis and premature cardiovascular events,” said senior author Professor Zanfina Ademi, Head of the Health Economics and Policy Evaluation Research (HEPER) group at Monash’s Centre for Medicine Use and Safety (CMUS) and a core member of the Lp(a) International Taskforce.

“Despite the risks, high Lp(a) remains dangerously underdiagnosed, with global testing prevalence reported to be exceedingly low. This significant oversight urgently demands international attention, which is why the FH Europe Foundation brought together an international taskforce to make Lp(a) testing routine and ensure equitable management across global populations.”

The research team designed a health economic model based on the population data which showed that Lp(a) testing could prevent 60 heart attacks, 13 strokes and 26 early deaths (per 10,000 people tested) and lead to 169 years of life gained and 217 years of living in good health in Australia. The researchers also found testing would save approximately $85 in societal costs (healthcare plus productivity burden) per person in Australia.

“Lp(a) testing to reclassify cardiovascular disease risk in the primary prevention population aged between 40 and 69 years would address a critical gap in cardiovascular disease prevention,” said study co-author Professor Florian Kronenberg, from the Medical University of Innsbruck. “However, testing at a markedly earlier age would make even more sense to avoid losing years of preventive measures.”

Study co-author Magdalena Daccord, CEO of FHEF, hopes to see this important work progress into clinical practice.

“Cardiovascular disease is a major global health concern and preventative measures such as Lp(a) testing is such a simple way to pinpoint those at higher risk and put interventions in place,” Daccord said. “We look forward to continuing to work with our international collaborators to drive change and improve health outcomes for individuals and their families around the globe.”

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