Catapano Alberico L, Tokgözoğlu Lale, Banach Maciej, Gazzotti Marta, Olmastroni Elena, Casula Manuela, Ray Kausik K
IRCCS MultiMedica, Sesto San Giovanni, MI, Italy; Epidemiology and Preventive Pharmacology Service (SEFAP), Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy.
Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Atherosclerosis. 2023 Apr;370:5-11. doi: 10.1016/j.atherosclerosis.2023.02.007. Epub 2023 Feb 23.
The European Atherosclerosis Society (EAS) Lipid Clinics Network promoted a survey in order to identify and understand how and when lipoprotein(a) [Lp(a)] is tested and clinically evaluated in lipid clinics throughout Europe, and the challenges that may prevent evaluation from being carried out.
This survey was divided into three areas of inquiry: background and clinical setting information of clinicians, questions for doctors who claimed not to measure Lp(a), in order to understand what were the reasons for not ordering the test, and questions for doctors who measure Lp(a), to investigate the use of this value in the management of patients.
A total of 151 centres clinicians filled in the survey, out of 226 invited. The proportion of clinicians who declare to routinely measure Lp(a) in clinical practice was 75.5%. The most common reasons for not ordering the Lp(a) test were the lack of reimbursement or of treatment options, the non-availability of Lp(a) test, and the high cost of performing the laboratory test. The availability of therapies targeting this lipoprotein would result in a greater propensity of clinicians to start testing Lp(a). Among those who declared to routinely measure Lp(a), the Lp(a) measurement is mostly requested to further stratify patients' cardiovascular risk, and half of them recognized 50 mg/dL (approx. 110 nmol/L) as the threshold for increased cardiovascular risk due.
These results warrant for a great deal of effort from scientific societies to address the barriers that limit the routine use of the measurement of Lp(a) concentration and to recognise the importance of Lp(a) as a risk factor.
欧洲动脉粥样硬化学会（EAS）脂质诊所网络开展了一项调查，以确定并了解在欧洲各地的脂质诊所中脂蛋白(a)[Lp(a)]是如何以及何时进行检测和临床评估的，以及可能妨碍进行评估的挑战。
本次调查分为三个询问领域：临床医生的背景和临床环境信息；针对声称不检测Lp(a)的医生的问题，以了解不进行该检测的原因；针对检测Lp(a)的医生的问题，以调查该指标在患者管理中的应用。
在受邀的226个中心中，共有151个中心的临床医生填写了调查问卷。宣称在临床实践中常规检测Lp(a)的临床医生比例为75.5%。不进行Lp(a)检测的最常见原因是缺乏报销或治疗方案、无法进行Lp(a)检测以及实验室检测成本高昂。有针对这种脂蛋白的治疗方法将使临床医生更倾向于开始检测Lp(a)。在那些宣称常规检测Lp(a)的医生中，进行Lp(a)检测主要是为了进一步分层患者的心血管风险，其中一半的人认为50mg/dL（约110nmol/L）是心血管风险增加的阈值。
这些结果表明，科学协会需要付出巨大努力来消除限制Lp(a)浓度检测常规使用的障碍，并认识到Lp(a)作为风险因素的重要性。
