Lipoprotein(a) Testing Patterns in a Large Health System
Section snippets
Methods
We extracted data from Duke University Healthcare System (DUHS) electronic health record (EHR). DUHS includes three hospitals and a network of outpatient clinics that have been integrated on an EHR system since 2014. This study received approval from the Duke Institutional Review Board.
Patients included in this study had at least one Lp(a) test between January 1, 2014 and October 10, 2019 (hereto referred to as Lp(a) cohort). A 4:1 date-matched control group included patients who had a
Results
Between January 1, 2014 and October 10, 2019, there were 2,088 Lp(a) lab tests results within DUHS on 1,926 individual patients. Among these, 1,296 patients had 2 prior encounters in the previous year to be included in the final analysis (Figure 1A). The LDL-C cohort was formed of 5,185 date-matched individuals (Figure 1B). The median Lp(a) value within the LP(a) cohort was 31mg/dL (Q1, Q3: 11, 78 mg/dL) (Figure 2).
Compared with date-matched controls with LDL-C but not Lp(a) testing,
Discussion
To our knowledge, this is the first study to characterize Lp(a) testing patterns in a real-world setting. We found that within a large academic health system, patients who underwent Lp(a) testing more frequently had a history of ASCVD, especially at younger ages, compared to those with LDL-C testing alone. Lp(a) was ordered by a variety of provider types, but the type with the highest proportion was neurology and psychiatry (a combined provider category within DUHS EHR). Those with Lp(a)
Disclosures
The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Neha Pagidipati reports financial support was provided by Amgen, INC.
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Disclosures/Acknowledgements: This study was supported by a grant from Amgen, Inc. MDK is supported by a National Institute of Health (NIH) training grant (NIH 5T32HL069749-17).