Testing
Global Lp(a) testing rose from 0.009% to just 0.032% of adults between 2015 and 2023, TriNetX analysis of 141 million patients finds (Am Heart J 2025)
Original title: Global lipoprotein (a) testing trends from 2015 to 2023
This retrospective cohort study used the TriNetX Global Collaborative Network, spanning 141 million patients across 144 healthcare organisations, to track Lp(a) testing trends among adults from January 2015 to December 2023, both overall and in guideline-relevant high-risk subgroups. Of 175,853 patients tested (mean age 59.0, SD 16.9, 50% women, 63% white), overall Lp(a) testing rose only from 0.009% in 2015 to 0.032% in 2023. High-risk subgroups also saw only modest gains: coronary artery disease rose from 0.24% to 0.85%, peripheral artery disease from 0.20% to 0.42%, ischaemic stroke from 0.61% to 0.71%, heart failure from 0.19% to 0.51%, family history of coronary disease from 0.24% to 1.29%, carotid stenosis from 0.37% to 0.90%, and aortic stenosis from 0.18% to 0.56%; by 2023, every subgroup except family history of coronary disease still had under 1% testing. This global dataset quantifies just how far routine practice lags behind guideline-recommended one-time Lp(a) testing, even in patients guidelines most clearly target.
Original abstract
Background: Lipoprotein (a) [Lp(a)] is a known cardiovascular disease risk factor. Recent guidelines recommend Lp(a) testing once in all individuals, especially in those with premature cardiovascular disease, and family history of cardiovascular disease. Emerging Lp(a) lowering therapies have the potential to mitigate this risk. However, the current global trends in Lp(a) testing remain unknown. This study aimed to evaluate global patterns in Lp(a) testing over the past decade, including trends in high-risk and key demographic subgroups.
Methods: We conducted a retrospective cohort study using the TriNetX Global Collaborative Network and identified comorbidities using the International Classification of Disease, Tenth Revision, and Clinical Modification (ICD-10-CM) codes. Study population included adults age (≥18 years) who underwent Lp(a) testing between January 2015 and December 2023. We assessed annual trends in Lp(a) testing overall and in high-risk subgroups, including coronary artery disease (CAD), peripheral artery disease (PAD), ischemic stroke, heart failure (HF), family history of CAD, carotid artery stenosis, and aortic stenosis.
Results: 141 million patients from 144 healthcare organizations were included. Lp(a) testing was conducted in 175,853 patients, with a mean age of 59.0 ± 16.9 years, 50% women and 63% white adults. Overall Lp(a) testing increased nominally from 0.009% in 2015 to 0.032% in 2023. Among different high-risk subgroups, Lp(a) testing was also considerably low and only had a modest gradual increase between 2015 and 2023 (CAD: 0.24%-0.85%; PAD: 0.20%-0.42%; Ischemic stroke: 0.61%-0.71%; HF: 0.19%-0.51%; Family history of CAD: 0.24%-1.29%; Carotid artery stenosis: 0.37%-0.90%; Aortic stenosis: 0.18%-0.56%). In 2023, all subgroups had <1% Lp(a) testing, except those with family history of CAD.
Conclusion: Global Lp(a) testing rates remain low overall and in high-risk subgroups, emphasizing the need for education and implementation of guideline-recommended testing and risk stratification.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 17 August 2026. Methods.