Lipoprotein (a) Discovery Project: Initiative to Identify Awareness and Models of Lipoprotein (a) Testing for National Education

Abstract

Study Funding

Novartis is proud to support the American Heart Association's Lp(a) Discovery Project.

Background/Synopsis

It is estimated that 1 in 5 Americans have high lipoprotein (a) [Lp(a)] levels. High levels of Lp(a) are an independent, predominantly inherited, and causal risk factor for atherosclerotic cardiovascular disease even in the setting of effective reduction of plasma low-density lipoprotein cholesterol. Race and ethnicity also play a role in Lp(a) regulation. There are currently no standard management approaches for diagnosis or risk assessment, nor any targeted treatments available to lower Lp(a).

Objective/Purpose

The American Heart Association (AHA) is implementing a national 3-year initiative called the Lp(a) Discovery Project to understand system-level practice patterns for patients tested for elevated Lp(a). We aim to improve the number of patients tested for Lp(a) by improving processes and workflows across care settings through dissemination of national testing models.

Methods

The AHA has engaged 10 champions from diverse health systems with established Lp(a) screening processes and workflows to participate in a Learning Healthcare System model called an Expert Forum. The health systems share best practices and inform on models for Lp(a) testing. Virtual, monthly AHA-led consultant interviews with the health systems are used to document existing provider and health system level Lp(a) testing processes, resources, and barriers. Findings are presented quarterly during virtual Expert Forum meetings, with all participating health systems, to come to consensus on models for national dissemination. Professional education topics identified during these calls are explored to build awareness for the importance of Lp(a) testing. Data on testing rates will be collected through the AHA's Get With The Guidelines (GWTG)-Stroke and GWTG-Coronary Artery Disease modules.

Results

From consultations, AHA found that Lp(a) testing awareness for providers and patients varies. There is inconsistent provider knowledge about the importance of Lp(a) testing for a patient's overall cardiovascular risk profile. Providers are sometimes reluctant to order an Lp(a) test because of lack of awareness of next steps for patients with elevated Lp(a), such as intensive management of other risk factors. There is also a need to educate providers on how to talk with their patients about Lp(a) testing and cascade testing for family members for those who have elevated Lp(a).

Conclusions

Improving provider and patient awareness of the importance of Lp(a) testing is critical to improving patient care. The Lp(a) Discovery Project is identifying gaps in patient and professional education for Lp(a), barriers to streamlined testing, and implementing strategies to improve national Lp(a) testing rates through professional education and patient resources.