# Variatie in Lp(a)-metingen kan patiënten verkeerd inschatten — methodenvergelijking

*geplaatst 2026-11-01 · Cholesterol · Clinical chemistry and laboratory medicine · doi 10.1515/cclm-2026-1481 · https://hartvaat.nl/2026/10/26/variatie-in-lp-a-metingen-kan-patienten-verkeerd-inschatten-methodenvergelijking/*

Een studie onderzocht de analytische prestaties van zes geautomatiseerde Lp(a)-assays en de consequenties voor cardiovasculaire risicotresholds. Hoewel de methoden goed correleerden, leidde de variatie tot een misclassificatierisico van tot 17,2% bij gebruik van de EAS of ACC/AHA-cutoffs. Dit benadrukt de noodzaak van standaardisatie en het gebruik van nmol/L om foutieve risicobeoordelingen in de klinische praktijk te voorkomen.

## English: Lipoprotein(a) analytical variation and cardiovascular thresholds.

An analytical comparison of six automated Lp(a) assays revealed significant method-dependent variability, leading to misclassification risks of up to 17.2% against established EAS and ACC/AHA cardiovascular thresholds. While inter-method correlations were strong, the lack of standardization can result in inconsistent risk stratification across laboratories. Clinicians should be aware of these analytical differences when interpreting Lp(a) results, highlighting the need for standardized reporting in nmol/L.

## Abstract (original, from the publication)

OBJECTIVES: The study was designed to evaluate the analytical performances of six automated immunoturbidimetric lipoprotein(a) (Lp(a)) assays, each corresponding to a combination of a reagent and an analyzer (Binding Site Optilite Lp(a) kit, Diagam Lp(a) reagent on Mindray BS480, Diagam Lp(a) reagent on Roche c502, Randox Lp(a) reagent on IDS-ISYS, Roche Tinaquant LPA2 on Roche c702 and Siemens Atellica CH Lp(a)/Atellica® CH 930) using results expressed in mg/dL or nmol/L. METHODS: Imprecision was assessed on manufacturer controls according to the CLSI EP15-A3 protocol. One hundred and 45 patient serum samples from the cardiology department were assessed to compare each method using Spearman's correlation, Passing-Bablok regression and Bland-Altman analyses. Percent agreement was calculated according to the European Atherosclerosis Society and American College of Cardiology/American Heart Association Lp(a) cut-offs for cardiovascular risk. RESULTS: All immunoturbidimetric methods achieved the desirable imprecision of 5.1 % based on biological variation. Highly significant correlations were found across multiple comparisons (p<0.001). The absolute mean of the difference according to Bland-Altman ranged between 0.4 and 2.6 for Lp(a) assays in mg/dL and between 0.6 and 6.5 for Lp(a) assays in nmol/L. The percent agreement between two assays varied from 87.6 to 96.6 % and from 82.8 to 93.8 % using the EAS or the ACC/AHA thresholds. CONCLUSIONS: Despite acceptable correlation among the six Lp(a) turbidimetric assays, a risk of "misclassifications" between two assays up to 12.4 % with the EAS recommendations and 17.2 % with the ACC/AHA guideline remains a major concern. Standardization of methods, including expression of results in nmol/L is needed.

Auteurs: Anne-Sophie Bargnoux, Amal Aamoum, Pierre-Edouard Grillet, Maëlle Plawecki, Anne-Marie Dupuy, François Roubille, Jean-Paul Cristol

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Bron: Clinical chemistry and laboratory medicine, https://doi.org/10.1515/cclm-2026-1481. Bijgewerkt 2026-10-26T01:57:43Z. 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.