Testing
44% of Singapore cardiology and endocrinology specialists never test for Lp(a), mainly citing no effective treatment (Front Cardiovasc Med 2025)
Original title: Deficient perceptions and practices concerning elevated lipoprotein(a) among specialists in Singapore
This survey of 75 practicing specialists in Singapore, 33 cardiologists and 42 endocrinologists, assessed awareness, knowledge and clinical practice regarding elevated Lp(a). While 83% rated their familiarity with Lp(a) as at least average, endocrinologists were more often unfamiliar than cardiologists (29% vs. 3%, P < 0.01), and only 57% were aware of any Lp(a) guideline or consensus statement, more often cardiologists than endocrinologists (70% vs. 48%, P = 0.05). Correct answers on prevalence, pathophysiology, clinical significance and management fell below 30%. Notably, 44% of respondents (33% of cardiologists, 52% of endocrinologists) never ordered Lp(a) testing, most commonly citing the lack of effective treatment (59%) as the barrier, and specialists who did not test rated their own familiarity as low more often than regular testers (33% vs. 13%, P = 0.02). The authors identify major knowledge and practice gaps and call for targeted specialist education to overcome testing barriers.
Original abstract
Background: Multiple guidelines recommend detection of and early risk factor management for elevated lipoprotein(a) [Lp(a)]. Effective implementation requires assessment of knowledge and practices regarding elevated Lp(a) among medical specialists.
Aim: To assess awareness, knowledge and practices of the detection and treatment of elevated Lp(a) among specialist physicians in Singapore.
Methods: Seventy-five practicing specialists in cardiology (n = 33) or endocrinology (n = 42) anonymously completed a structured questionnaire that assessed the above three aims.
Results: The majority of respondents (83%) rated their familiarity with Lp(a) as at least average, with a greater percentage of endocrinologists being less familiar with Lp(a) than cardiologists (29% vs. 3%, P < 0.01). 57% were aware of at least one guideline or consensus statement on Lp(a), which was more frequent among cardiologists than endocrinologists (70% vs. 48%, P = 0.05). There were major gaps in knowledge of the prevalence, pathophysiological role, clinical significance and management of elevated Lp(a), correct responses being less than 30%; 44% of respondents (33% cardiologists and 52% endocrinologists) never tested for Lp(a), lack of effective treatment being the most common barrier (59%). A higher proportion of specialists that did not test for Lp(a) rated familiarity with Lp(a) as being low compared with specialists that tested for Lp(a) regularly (33% vs. 13%, P = 0.02). Education and training were considered most useful for improving care of patients with elevated Lp(a).
Conclusion: Major gaps in awareness, knowledge and management of elevated Lp(a) were identified among specialists in Singapore. Education and training of specialists are required to overcome initial barriers to testing.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.