Aortic stenosis
Lp(a) is rarely tested before cardiac rehab despite high prevalence, German registry of 3,393 (Clin Res Cardiol 2026)
Original title: Prevalence of elevated lipoprotein(a) in cardiac rehabilitation patients - results from a large-scale multicentre registry in Germany
Non-interventional registry across MEDIAN cardiac rehabilitation facilities in Germany, 3393 patients across four cohorts: aortic valve intervention (n=1063), myocardial infarction below age 60 with current (n=1351) or previous (n=381) MI, and MI at 60 or older as control (n=598), assessing prior Lp(a) testing and prevalence of elevated levels. Lp(a) had been measured at the referring hospital in only 0.19% (aortic valve), 4.96% (MI <60 current), 2.36% (MI <60 previous) and 2.01% (control) of patients. Elevated Lp(a) (above 50 mg/dL or 125 nmol/L) was found in 28.79% (aortic valve), 29.90% and 36.48% (the two premature-MI cohorts, p<0.001) versus 24.25% (control); family history of premature cardiovascular disease was likewise more common in the premature-disease cohorts (13.45-38.56%) than control (17.89%, p<0.05 for each comparison). The authors conclude Lp(a) is rarely assessed in acute management of aortic stenosis or premature MI despite its above-average prevalence in these groups, calling for substantially greater awareness.
Original abstract
Background: Lipoprotein(a) (Lp(a)) is an independent risk factor for myocardial infarction and aortic valve stenosis. European guidelines recommend assessing it at least once in a lifetime, particularly in premature atherosclerotic heart disease.
Methods: A non-interventional registry was conducted at MEDIAN rehabilitation facilities in Germany to assess the frequency of Lp(a) testing in referring acute care hospitals and the prevalence of elevated Lp(a) levels in aortic valve stenosis or premature myocardial infarction. All consecutive patients referred after coronary intervention or aortic valve surgery were included in four cohorts: aortic valve intervention (cohort 1), current/previous myocardial infarction at < 60 years of age (cohorts 2a/2b), and myocardial infarction at ≥ 60 years of age (control).
Results: The analysis included 3393 patient records (cohort 1, n = 1063; cohort 2a, n = 1351; cohort 2b, n = 381; control, n = 598). Lp(a) had been determined at the referring hospital in 0.19% (cohort 1), 4.96% (cohort 2a), 2.36% (cohort 2b), and 2.01% (control) of patients. Lp(a) levels were > 50 mg/dL or > 125 nmol/L in 28.79% (cohort 1), 29.90% (cohort 2a), and 36.48% (cohort 2b; p < 0.001) compared to 24.25% (control). Family history of premature cardiovascular disease was reported in 13.45% (cohort 1), 38.56% (cohort 2a), and 32.81% (cohort 2b) compared to 17.89% (control; p < 0.05 for each comparison).
Conclusions: Lp(a) had been rarely assessed in acute management of aortic valve stenosis or premature myocardial infarction despite expanding scientific evidence and guideline recommendation. Given the above-average incidence of elevated Lp(a) levels, awareness for Lp(a) has to increase substantially to better identify and manage high-risk patients.
ancestryaortic stenosistesting
Summary written by lp-a.org from the published abstract; figures as published. Page updated 17 August 2026. Methods.