Testing
Lp(a) varies little within individuals, repeat testing rarely needed, cohort of 250 (J Clin Lipidol 2026)
Original title: Intraindividual variability in lipoprotein(a)
Retrospective study of 250 patients from a UK tertiary lipid clinic with 2 or more Lp(a) measurements over a mean 17.1±15.5 months, quantifying intraindividual variability and its impact on cardiovascular risk classification. Baseline Lp(a) was right-skewed (median 56.0 nmol/L, IQR 21.0-154.3). Intraindividual coefficients of variation were 19.0% (mean-based) and 33.6% (log-transformed), exceeding the EFLM reference database value of 10.2% (95% CI 4.3-26.7%). Cardiovascular risk reclassification occurred in 12.4% of patients using National Lipid Association thresholds (75 and 125 nmol/L) and 6.8% using the European Society of Cardiology threshold (105 nmol/L); variability was not associated with time between tests, medications, or biochemical parameters. The authors conclude repeat Lp(a) testing is generally unnecessary, but could be considered for patients near risk thresholds or being evaluated for Lp(a)-lowering therapy.
Original abstract
Background: Lipoprotein(a) [Lp(a)] is an independent risk factor for atherosclerotic cardiovascular disease. Although Lp(a) levels are generally stable, the extent of intraindividual variation and the need for repeat Lp(a) testing remain unclear.
Objective: To evaluate the intraindividual variation in Lp(a) levels assess the clinical impact of repeat testing on cardiovascular risk classification.
Methods: This retrospective study analyzed 250 patients from a tertiary care lipid clinic with ≥2 Lp(a) measurements over a mean of 17.1 ± 15.5 months.
Results: Baseline levels were positively skewed (median of 56.0 nmol/L; interquartile range 21.0-154.3 nmol/L). Intraindividual coefficients of variation (CV) were 19.0% (mean-based) and 33.6% (log-transformed), exceeding the European Federation of Clinical Chemistry and Laboratory Medicine database CV (10.2%; 4.3%-26.7%). Cardiovascular risk reclassification occurred for 12.4% using the National Lipid Association thresholds (75 and 125 nmol/L) and 6.8% using the European Society of Cardiology threshold (105 nmol/L). Variability was not associated with time between measurements, medications, or biochemical parameters on multivariable analysis.
Conclusion: Hence, repeat Lp(a) testing is generally unnecessary but could be considered in those near risk thresholds or those being evaluated for Lp(a)-lowering therapies.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 17 August 2026. Methods.