Real-world impact of transitioning from one lipoprotein(a) assay to another in a clinical setting

• Main Authors: Janeni Jeevanathan (Author), Sigrid M. Blom (Author), Thomas Olsen (Author), Kirsten B. Holven (Author), Erik K. Arnesen (Author), Torleif Trydal (Author), Børge G. Nordestgaard (Author), Michael Sovershaev (Author), Ying Chen (Author), Kjetil Retterstøl (Author), Jacob J. Christensen (Author)
• Format: Book
• Published: Elsevier, 2024-09-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 2666-6677; 10.1016/j.ajpc.2024.100726
• Keywords: Lipids; Lipoprotein(a); Lipoprotein(a) assay; Diseases of the circulatory (Cardiovascular) system; RC666-701; Public aspects of medicine; RA1-1270
• Source: American Journal of Preventive Cardiology, Vol 19, Iss , Pp 100726- (2024)

Background and aims: Different lipoprotein(a) [Lp(a)] assays may affect risk stratification of individuals and thus clinical decision-making. We aimed to investigate how transitioning between Lp(a) assays at a large central laboratory affected the proportion of individuals with Lp(a) result above clinical thresholds. Methods: We studied nationwide clinical laboratory data including 185,493 unique individuals (47.7 % women) aged 18-50 years with 272,463 Lp(a) measurements using Roche (2000-2009) and Siemens Lp(a) assay (2009-2019). Results: While the majority of individuals (66-75 %) had low levels of Lp(a) (<30 mg/dL) independent of the assay used, the Roche assay detected 20 % more individuals with Lp(a) >50 mg/dL, 40 % more individuals with Lp(a) >100 mg/dL and 80 % more individuals with Lp(a) > 180 mg/dL than the currently used Siemens assay, likely due to calibration differences. Conclusion: Transitioning from one Lp(a) immunoassay to another had significant impact on Lp(a) results, particularly in individuals approaching clinically relevant Lp(a) thresholds.