Division of Diabetes, Endocrinology and Metabolism, Imperial College London, London, UK (Dr Ansari and Cegla); Lipids and Cardiovascular Risk Service, Department of Cardiology, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK (Dr Ansari and Cegla).
Department of Blood Sciences and NIHR MedTech and IVD Centre, Newcastle Upon Tyne Hospitals, Newcastle Upon Tyne, UK (Dr Neely).
J Clin Lipidol. 2024 May-Jun;18(3):e477-e481. doi: 10.1016/j.jacl.2024.02.004. Epub 2024 Feb 15.
Lipoprotein(a) is an independent risk factor for cardiovascular disease and its use is recommended in national and international guidelines for cardiovascular disease risk stratification. We undertook a survey to understand the availability and application of lipoprotein(a) measurement across UK lipid clinics. Fifty-three out of an estimated 200 lipid clinics (27%) provided responses. Eighty-one percent of 53 clinics had access to lipoprotein(a) measurement. Twenty-seven clinics disclosed the number of lipoprotein(a) tests ordered annually with approximately half of the clinics (52%) requesting 0-250 tests per year. Sixty percent measured lipoprotein(a) once per patient and the leading indication was a personal or family history of premature history of cardiovascular disease in those <60 years old. Sixty-three percent of clinics that provided comments with lipoprotein(a) results graded cardiovascular risk as per the HEART UK consensus statement. Sixty percent of clinics performed family cascade testing on lipoprotein(a) results ≥200 nmol/L. Lipoprotein(a) was reported in nmol/L, mg/dL, or mg/L by 48%, 24%, and 28% of responding clinics, respectively. National effort is required to provide universal access to lipoprotein(a) measurement and to harmonise the clinical application of this data.
脂蛋白(a)是心血管疾病的独立危险因素，其在国家和国际心血管疾病风险分层指南中被推荐使用。我们进行了一项调查，以了解英国脂质诊所中脂蛋白(a)检测的可用性和应用情况。在估计的 200 家脂质诊所中，有 53 家做出了回应。81%的 53 家诊所能够进行脂蛋白(a)检测。27 家诊所公布了每年订购的脂蛋白(a)检测数量，其中约一半的诊所（52%）每年要求进行 0-250 次检测。60%的诊所对每位患者进行一次脂蛋白(a)检测，主要指征是 60 岁以下的个人或家族有早发心血管疾病史。63%提供脂蛋白(a)结果注释的诊所根据英国心脏协会共识声明对心血管风险进行分级。60%的诊所对脂蛋白(a)结果≥200nmol/L 的患者进行家族级联检测。分别有 48%、24%和 28%的参与诊所以 nmol/L、mg/dL 或 mg/L 报告脂蛋白(a)。需要进行国家层面的努力，以提供脂蛋白(a)检测的普遍可及性，并协调该数据的临床应用。
