Testing
Patients with prior ASCVD and Lp(a) above 90 mg/dL rack up 2.5 times higher healthcare costs and more MACE than those with normal Lp(a), Alberta real-world study of 29,229 finds (Atherosclerosis 2025)
Original title: Characterization of lipoprotein (a) testing in Alberta, Canada: a retrospective cohort study
This retrospective observational study analysed Alberta, Canada's population-level administrative health data for 29,229 individuals with Lp(a) testing between 2015 and 2023, of whom 7,787 (26.6%) had prior atherosclerotic cardiovascular disease (ASCVD), stratified by ASCVD status and Lp(a) level (50, 70, and 90 mg/dL thresholds). Healthcare resource use, costs, lipid-lowering therapy intensification, and major adverse cardiovascular events (MACE) were generally highest among those with both prior ASCVD and elevated Lp(a). Median total costs and MACE rates per 1,000 person-years rose with Lp(a) threshold among ASCVD patients: $9,315 and 32.7 events above 50 mg/dL, $11,828 and 34.2 events above 70 mg/dL, and $14,835 and 33.1 events above 90 mg/dL, compared with $5,976 and 27.0 events in those with lower Lp(a). This large real-world Canadian dataset quantifies the substantial added healthcare burden of elevated Lp(a) specifically in patients who already have established cardiovascular disease.
Original abstract
Background And Aims: Patients with elevated lipoprotein (a) (Lp(a)) levels face increased risk of cardiovascular events. However, Lp(a) testing has only recently been recommended as routine clinical practice. This study examines real-world baseline characteristics, healthcare resource utilization (HCRU), costs, lipid-lowering therapy (LLT) treatment intensification, and major adverse cardiovascular events (MACE) among individuals with Lp(a) testing.
Methods: This retrospective, observational study analyzed population-level administrative health data from Alberta, Canada. Individuals with Lp(a) testing were indexed on the first Lp(a) test date occurring between January 1, 2015 and March 31, 2023 and stratified by prior atherosclerotic cardiovascular disease (ASCVD) status and Lp(a) levels (≤50, >50, >70, and >90 mg/dL).
Results: The study included 29,229 individuals with Lp(a) testing, of which 7787 (26.6 %) had prior ASCVD. HCRU/costs in the year prior to index, and LLT intensification and MACE rates during follow-up were generally highest in individuals who had both prior ASCVD and an elevated Lp(a) level. Median total costs (per 100 patient-years) and MACE rates (95 % confidence interval, per 1000 person-years) were numerically higher in patients with prior ASCVD who also had elevated Lp(a) levels [>50 mg/dL: $9,315, 32.7 (26.6-38.9); >70 mg/dL: $11,828, 34.2 (26.7-41.6); >90 mg/dL $14,835; 33.1 (24.1-42.1)] compared to those with lower Lp(a) levels ($5,976, 27.0 (23.8-30.4)).
Conclusions: Individuals with elevated Lp(a) levels and prior ASCVD had numerically greater HCRU/costs and subsequent MACE rates. Understanding of the characteristics and outcomes in the context of ASCVD status is important to develop risk assessment and management strategies for those with elevated Lp(a).
Summary written by lp-a.org from the published abstract; figures as published. Page updated 17 August 2026. Methods.