Testing
The Batary survey of 49 Spanish laboratories finds most lack Lp(a) testing protocols despite 46.87% of results exceeding 30 mg/dL (Clin Investig Arterioscler 2025)
Original title: Analysis of lipoprotein (a) determination in a selection of Spanish Clinical Laboratories. Batary study
This retrospective, multicentre survey of 49 clinical laboratories across Spain, conducted in 2022, analysed 21,926 Lp(a) determinations to assess the state of pre-analytical, analytical and post-analytical Lp(a) testing practice. Of tested results, 46.87% exceeded 30 mg/dL, 35.31% exceeded 50 mg/dL, 26.8% exceeded 70 mg/dL, and 19.3% exceeded 90 mg/dL, with women predominating above every cutoff. Despite this substantial burden of elevated results, almost 30% of primary care physicians lacked access to Lp(a) testing, 56.9% of laboratories had no rejection criteria for samples, and 70.6% had no formal determination protocol; laboratories were also split between immunonephelometry (40%) and immunoturbidimetry (60%) methods and inconsistent reporting units (24% nmol/L, 68% mg/dL, 8% both). The authors conclude that both access to Lp(a) testing and standardisation of laboratory processes in Spain fall well short of what the observed prevalence of elevated Lp(a) would warrant.
Original abstract
Introduction: Lipoprotein a is considered an independent factor of atherosclerotic cardiovascular disease with high prevalence, but the availability of real and updated data in Spain as well as determination protocols are limited.
Main Objective: Analyze the current state of the pre-analytical, analytical and post-analytical process of Lp (a) and assess the relationship with other variables.
Material And Method: Retrospective, observational, multicenter, anonymized study carried out in 2022 by survey of clinical laboratories.
Results: 21,926 determinations were obtained corresponding to 49 Laboratories. The values obtained were: Lp(a)>30mg/dl=46.87%, Lp(a)>50mg/dl 35.31%, Lp(a)>70mg/dl=26.8% Lp(a)>90mg/dl=19.3% with predominance of superiority in female gender in all established cut-off points. Almost 30% of primary care doctors do not have access to their application. 56.9% do not have a rejection criterion. 70.6% do not have protocols for its determination. There are two predominant analytical techniques, Immunophelometry (40%) and immunoturbidimetry (60%), 24% use nmon/L, 68% mg/dL and 8% report both.
Conclusions: There is a low number of patients who have Lp(a) measured and of them the percentage of patients according to risk cut-off points are higher than those described. There is a lack of uniformity in pre-analytical, analytical and post-analytical processes in which it is necessary to work in a multidisciplinary manner to avoid future cardiovascular events.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.