{"id":"46056","type":"article","url":"https://hartvaat.nl/2026/04/21/lp-a-bepaling-sterk-onderbenut-bij-patienten-met-atherosclerotische-hart-en-vaat/","title":"Lp(a)-bepaling sterk onderbenut bij patiënten met atherosclerotische hart- en vaatziekten (Australië)","title_en":"Prevalence of Lipoprotein(a) Testing in Patients With Atherosclerotic Cardiovascular Disease Within a Large Australian Cardiology Network.","category":"cholesterol","category_label":"Cholesterol","professions":["cardioloog","huisarts"],"tags":[],"journal":"Heart, lung & circulation","doi":"10.1016/j.hlc.2025.11.017","source_url":"https://doi.org/10.1016/j.hlc.2025.11.017","authors":["David Eccleston","Enayet K Chowdhury","Anna Williamson","Meherin Rahman","Catherine Sciascia","Ravi Santani","Renae Deans"],"significance":5,"published":"2026-07-18","source_date":"2026-04-21","image":"","kennis":["https://hartvaat.nl/kennis/lipiden/lpa-meten-wanneer-waarom/","https://hartvaat.nl/kennis/lipiden/lp-a-verhoogd/"],"congress":"","summary_en":"Elevated lipoprotein(a) (Lp(a)) is a genetically determined causal risk factor for atherosclerotic cardiovascular disease (ASCVD). This retrospective study analysed over 1.1 million de-identified records from a large Australian cardiology network (2011-2022) using natural language processing. Lp(a) testing in ASCVD patients was rare but rising: from 0.9% in the historical cohort to 2.6% in 2022. Of tested patients with a recorded value, 25% had Lp(a) >90 mg/dL (historical) and 30% ≥70 mg/dL (recent), while 87% were already on lipid-lowering therapy. Despite guidelines recommending testing, Lp(a) measurement remains markedly underused — a missed opportunity to identify high-risk patients, especially as targeted Lp(a)-lowering therapies are in development.","created":"2026-07-03T20:27:11Z","updated":"2026-07-04T19:26:57Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Een verhoogd lipoproteïne(a) (Lp(a)) is een genetisch bepaalde, causale risicofactor voor atherosclerotische hart- en vaatziekten (ASCVD). In dit retrospectieve onderzoek werden ruim 1,1 miljoen geanonimiseerde dossiers uit een groot Australisch cardiologienetwerk (2011-2022) geanalyseerd met natuurlijke-taalverwerking. Lp(a)-bepaling bij ASCVD-patiënten was zeldzaam maar nam toe: van 0,9% in het historische cohort naar 2,6% in 2022. Van de geteste patiënten met een bekende waarde had 25% een Lp(a) >90 mg/dl (historisch) en 30% ≥70 mg/dl (recent), terwijl 87% al lipidenverlagende therapie gebruikte. Ondanks richtlijnen die testen aanbevelen, blijft Lp(a)-bepaling dus sterk onderbenut — een gemiste kans om hoogrisicopatiënten te identificeren, zeker nu gerichte Lp(a)-verlagende therapieën in ontwikkeling zijn.","abstract_original":"BACKGROUND: Increased lipoprotein(a) (Lp[a]) is a genetically determined causal risk factor for atherosclerotic cardiovascular disease (ASCVD). Historically, Lp(a) testing has been uncommon in Australia. This study aims to assess the prevalence and trends in Lp(a) testing in Australia, and the associated patient characteristics. METHOD: This retrospective cross-sectional study examined over 1.1 million de-identified electronic medical records from patients seen in the Advara HeartCare network from 2011 to 2022. Adult patients from 2011 to 2021 comprised the historical group, while those from 2022 formed the baseline group. A natural language processing algorithm identified patients with ASCVD and Lp(a) testing, and extracted demographics, characteristics, and cardiovascular comorbidities from clinical letters. Patients with ASCVD in the baseline group were followed up for 18 months to assess trends in Lp(a) testing. RESULTS: Testing Lp(a) was infrequent among patients with ASCVD but increased gradually over time. In the historical cohort, of 164,121 patients identified with ASCVD, 1,501 (0.9%) underwent Lp(a) testing. Of these, 44.8% had Lp(a) levels <30 mg/dL, and 25.0% >90 mg/dL. In the baseline cohort, 1,460 (2.6%) of 55,427 patients with ASCVD underwent Lp(a) testing. Of 730 with recorded Lp(a) values, 30.2% had Lp(a) levels ≥70 mg/dL, and 86.8% were on lipid-lowering therapy. Dyslipidaemia was the most common comorbidity (72.8%), followed by Stage 1 or 2 chronic kidney disease (40.1%). During 18-month follow-up from the baseline period, 329 additional patients underwent Lp(a) testing in 2023. CONCLUSIONS: The study revealed that Lp(a) testing is underutilised among patients with ASCVD in Australia despite recent guidelines recommending it. This emphasises the need to expand Lp(a) testing to improve health outcomes for high-risk patients."}