Key result
Lp(a) testing reclassifies ~22% of low-to-moderate risk individuals to a higher cardiovascular risk category.
Why the study?
Does Lipoprotein(a) testing reclassify cardiovascular risk and alter statin eligibility in subjects with low or moderate risk by SCORE2?
Cross-Sectional (n=140)
Does Lipoprotein(a) testing reclassify cardiovascular risk and alter statin eligibility in subjects with low or moderate risk by SCORE2?
Answers are grounded in this paper and cite their sources.
Routine Lipoprotein(a) testing in patients with low or moderate cardiovascular risk by SCORE2 significantly reclassifies risk upwards and increases eligibility for statin therapy.
Background: Lipoprotein(a) [Lp(a)] is a modifier of cardiovascular risk, and it should be determined at least once in a lifetime. Methods: Subjects with low or moderate cardiovascular risk, estimated by SCORE2, were invited to have a determination of Lp(a), and those with Lp(a) > 50 mg/dL were classified into a higher-risk category. Eligibility of statins was assessed according to treatment targets. Results: We analyzed 140 subjects, with a mean age of 54.3 (8.1) years and 62.9% women. The median Lp(a) was 15.2 (interquartile range: 6.7-44.5) mg/dL, and 22.1% of the cohort had Lp(a) > 50 mg/dL. No differences were observed in mean age, sex, or lipid profile in subjects with Lp(a) below or above 50 mg/dL; alkaline phosphatase (ALP) was significantly higher in subjects with Lp(a) > 50 mg/dL. After incorporating Lp(a) values into the SCORE-2 assessment, 22.6% of individuals initially of low risk were reclassified as moderate risk, and 77.4% were reclassified from moderate to high risk; moreover, 61.4% (86 subjects) were considered eligible for treatment with statins. Conclusions: Our results highlight that 22.1% of the subjects classified as low or moderate cardiovascular risk by SCORE-2 are reclassified to higher risk, and 61.4% were eligible for statin treatment as a result of Lp(a) testing.
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Cordero et al. (2025) conducted a cross-sectional in Low or moderate cardiovascular risk (n=140). Lipoprotein(a) testing vs. Standard SCORE2 assessment was evaluated on Reclassification to a higher cardiovascular risk category. Lipoprotein(a) testing in subjects with low or moderate cardiovascular risk led to 22.1% being reclassified to a higher risk category and 61.4% becoming eligible for statin treatment.
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