Abstract Body: Lipoprotein (a) [Lp(a)] is a type of lipoprotein that is genetically inherited. Elevated levels of Lp(a) are an independent and causal risk factor for atherosclerotic cardiovascular diseases through mechanisms associated with increased atherogenesis, inflammation, and thrombosis. Having elevated Lp(a) can increase risk of heart attack, stroke, and peripheral artery disease.
It is estimated that as many as 20% of the American population have elevated Lp(a) levels. There are currently no specific targeted treatments to lower Lp(a). There are currently no universal guidelines for diagnosing and providing risk assessment. There is a clinical need to understand variation in Lp(a) levels in various ancestry groups.
In March 2023, a field to include measures for Lp(a) was added to the Get With The Guidelines® IQVIA Registry Platform™ (GWTG). This registry is utilized by each of the hospitals in a current six hospital system. A configurable measure report including Lp(a) measurement obtained and Lp(a) level was added in April 2024.
Methods
Beginning in January 2024, Lp(a) levels obtained at six hospitals in our health system in New York City have been entered into GWTG. We used the newly developed measure reports for patients with ischemic stroke and TIA to determine whether Lp(a) levels were being obtained during hospitalization for stroke, and prior to these events. These hospitals are all certified by The Joint Commission®, and include one academic comprehensive stroke center, two thrombectomy centers, and three primary stroke centers.
Results
In general, measurement of Lp(a) was low. Only one hospital had more than 10% of patients where Lp(a) was measured. One hospital, a primary stroke center had significantly more patients tested due to specific interest in Lp(a). The hospital with the highest percentage of measurement prior to the stroke was a tertiary care academic hospital.
Conclusion
These results point out the need for initiatives across our health system to raise awareness of Lp(a) as an emerging stroke risk factor, and to improve on its measurement. This data will serve as a baseline to evaluate improvement in recognition and eventually treatment of elevated Lp(a) values.