Only 0.5% of 150,083 Mexican tertiary-care patients were tested for Lp(a), and just 26% of those with elevated levels got risk-modifying treatment (Lipids Health Dis 2025)

Original title: Lipoprotein (a) levels and clinical decision-making: data from a Mexican cohort at a tertiary medical institution

Lipids Health Dis · 26 May 2025 · 7

Cruz-Bautista I, Flores-Jurado Y, Roa-Álvarez G, Salas-Aldana M, Elías-Lopez DB, Hernández-Franco RF, Rosales-Uvera S, Vargas-Vázquez A, Valdez-Echeverría R, Luna Del Villar Velasco S, Muñoz-Hernández L, Mehta R et al.

This study reviewed clinical and biochemical data from a Mexican tertiary medical institution between 2019 and 2024 to characterise Lp(a) testing frequency and resulting clinical actions. Of 150,083 individuals evaluated at the institution, only 830 (0.5%) underwent Lp(a) testing, though the rate rose from 0.037% in 2019 to 0.24% in 2023. Elevated Lp(a) (above 50 mg/dL) was found in 21% of tested patients, with 2.2% above 180 mg/dL; those with elevated Lp(a) had significantly higher rates of atherosclerotic cardiovascular disease (P < 0.001) and familial hypercholesterolaemia (P < 0.004), while diabetes was unexpectedly more prevalent in those with very low Lp(a) below 4 mg/dL (51.5% vs. 33.4%, P < 0.001). Despite the elevated cardiovascular risk identified, only 26% of patients with elevated Lp(a) received interventions to modify risk factors. The authors conclude Lp(a) testing remains rare in this tertiary Mexican setting and that clinical follow-through even after a positive test is insufficient, calling for greater provider awareness and structured screening algorithms.

Original abstract

Background And Objective: Approximately 20% of the global population has a Lp(a) concentrations above 50 mg/dL (> 125nmol/L), yet many remain unaware of the associated cardiovascular risks. In Mexico, routine measurement of Lp(a) is uncommon. This study aimed to investigate the frequency of Lp(a) testing, and the clinical actions taken by physicians upon detecting elevated Lp(a) concentrations in patients at a tertiary medical institution.

Methods: Using an algorithm-based screening system, we reviewed the clinical and biochemical data of patients with Lp(a) measurements from 2019 to 2024. Data were retrieved from the laboratory information system and electronic health records. Complementary assessment data were obtained from the radiology and cardiology departments.

Results: Of the 150,083 individuals evaluated at the institution, only 830 (0.5%) underwent Lp(a) testing, with testing rates increasing from 0.037% in 2019 to 0.24% in 2023. Elevated Lp(a) concentrations (> 50 mg/dL) were found in 21% of patients, and 2.2% had concentrations > 180 mg/dL. Patients with elevated Lp(a) had significantly higher rates of atherosclerotic cardiovascular disease (ASCVD) (p < 0.001) and familial hypercholesterolemia (p < 0.004) than those with lower Lp(a) levels. Interestingly, diabetes prevalence was higher in those with Lp(a) < 4 mg/dL (51.5% vs. 33.4%, p < 0.001). Despite the cardiovascular risk, only 26% of patients with elevated Lp(a) levels received interventions to modify risk factors.

Conclusions: Lp(a) testing was infrequent in a tertiary medical setting. Clinical interventions to modify cardiovascular risk factors were insufficient among patients with elevated Lp(a). These findings highlight the need for greater awareness among healthcare providers and the development of comprehensive screening and management algorithms to mitigate Lp(a) -related cardiovascular risk.

Summary written by lp-a.org from the published abstract; figures as published. Page updated 17 August 2026. Methods.