Testing
Lp(a) testing is performed in only 0.34% of German patients, but when done, is linked to better cardiovascular outcomes, an analysis of 4 million claims records (Atherosclerosis 2023)
Original title: Trends and consequences of lipoprotein(a) testing: Cross-sectional and longitudinal health insurance claims database analyses
Using cross-sectional and longitudinal claims data from 4 million German patient records followed for up to 4 years, the authors characterised patients undergoing Lp(a) testing and its association with treatment and outcomes. Testing rates were low, 0.25% in 2015 and 0.34% in 2018, more common in younger women overall and in men within the ASCVD population. Patients tested for Lp(a) had more comorbidities, higher cardiovascular risk, and more frequent ASCVD hospitalisations before testing (5.55 vs 1.42 per 100 person-years) than matched controls. Among patients with prior ASCVD, mortality was lower in those tested for Lp(a) than matched untested controls (2.30 vs 3.64 per 100 person-years, P<0.001), and tested patients received more laboratory monitoring, cardiovascular medications, and specialist visits. The findings support Lp(a) testing as a marker of, and potential catalyst for, more intensive ASCVD prevention.
Original abstract
Background And Aims: Lipoprotein(a) (Lp(a)) is associated with an increased risk of atherosclerotic cardiovascular disease (ASCVD). Our goal was to characterize patients undergoing Lp(a) testing and to assess the impact of Lp(a) testing on treatment changes and subsequent ASCVD events.
Methods: A cross-sectional and a longitudinal claims data analysis were performed on 4 million patient records in Germany. Patients were followed up for a maximum of 4 years.
Results: In 2015 and 2018, 0.25% and 0.34% of patients were tested, respectively. Testing was more frequent in younger women in the overall population, and in men in the ASCVD population. Patients tested for Lp(a) had more comorbidities and higher ASCVD risk compared to matched control patients. ASCVD hospitalizations were more frequent prior to the first Lp(a) test (5.55 vs 1.42 per 100/person-years). The mortality rate of the Lp(a)-tested cohort and the control group was similar. Mortality was lower in patients with prior ASCVD and Lp(a) testing compared to matched controls with prior ASCVD and no Lp(a) test (2.30 vs 3.64 per 100/person-years, p <0.001). Patients with Lp(a) test received more laboratory examinations and cardiovascular medications and had more visits with specialized physicians.
Conclusions: Lp(a) testing is rarely performed even in patients with very high cardiovascular risk. Patients tested for Lp(a) have more comorbidities and a higher ASCVD risk. Lp(a) testing is associated with more intensive preventive treatment and with positive effects on clinical outcomes and survival. The data support the value of Lp(a) measurements to characterize ASCVD risk and to improve ASCVD prevention.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.