Value of repeated measurements of lipoprotein (a) to assess cardiovascular risk: a retrospective study

Abstract

Background: High plasma concentrations of lipoprotein (a) [Lp(a)] are associated with an increased cardiovascular risk. Current guidelines recommend measurement of only a single Lp(a) in an individual’s lifetime under specific circumstances to improve cardiovascular risk prediction. Accordingly, the question raised is the number of false positives and negatives missed through only a single measurement.

Methods: All Lp(a) measurements between 2004 and March 2021 were retrieved from the laboratory database of the Erasme hospital. Only patients with repeated measurement were included. The first and subsequent Lp(a) measurement were compared. Two different cohorts were studied as a result of a change in Lp(a) determination methodology (n = 2049 and n = 309, respectively). The effects of a third Lp(a) measurement were assessed through binary analyses (n = 678). The 180 mg/dl (430 nmol/L) threshold recommended in the ESC guidelines was assessed first. Analysis was repeated for 100, 70 and 50 mg/dl thresholds of raised Lp(a) levels.

Results: A low rate of false negatives (0.8%–1%) and false positives (0.6–0.3%) were revealed with two Lp(a) measurements. There was no difference in regards to the divergent Lp(a) thresholds nor the measurement of Lp(a) on two or three occasions.

Conclusion: The present study showed Lp(a) determination to be reproducible. A single measurement is sufficient to assess if a patient exceeds various cut-off values of elevated Lp(a) levels.

Keywords:

• Lipoprotein (a)
• cardiovascular risk

Authors contributions

A.D: database editing and analysis, participated in the statistical analysis, and wrote the manuscript under supervision; N.G: participated in the statistical analysis; P.v.d.B: original study idea, reviewed the manuscript; S.M: reviewed the manuscript

Disclosure statement

No potential conflict of interest was reported by the author(s).