Recently formed Lipoprotein(a) Taskforce publishes Call to Action to increase recognition and acceptance of Lp(a) as an ASCVD risk factor
- The recently established Lipoprotein(a) Taskforce (Lp(a) Taskforce) has published its first Call to Action report, encouraging greater recognition and acceptance of Lp(a) as an atherosclerotic cardiovascular disease (ASCVD) risk factor
- Lp(a) is an independent, inherited, and causal risk factor for ASCVD, and therefore serves as a vital indicator of individual susceptibility to several related conditions, including myocardial infarctions, stroke, coronary heart disease, peripheral arterial disease, and heart failure
- Despite being a well-established risk factor for these conditions, Lp(a) is not routinely measured in clinical practice and lacks representation in appropriate UK clinical guidelines
The recently formed Lp(a) Taskforce – comprising leading experts across the lipid, cardiovascular disease and laboratory community – has published its recommendations for increasing recognition and acceptance of Lipoprotein(a) – also known as ‘lipoprotein little a’ or Lp(a) – in UK clinical practice, in light of the growing body of evidence that shows it is an independent, inherited, and causal risk factor for ASCVD.
Despite the absence of specific Lp(a) lowering therapies, the Lp(a) Taskforce strongly believe that there is value in identifying patients with high Lp(a) concentrations to inform more intensive and personalised ASCVD risk factor management of LDL-C, blood pressure, glucose, and lifestyle factors. This is particularly important given that approximately 1 in 5 people are estimated to have elevated levels of Lp(a), alongside the estimate that elevated Lp(a) concentration is associated with 5% of CVD events.
To achieve this, the Lp(a) Taskforce believe there is a need for greater awareness and identification of Lp(a) across the system, including how initiatives in this area can transform approaches to CVD prevention and care.
To support these ambitions, the Lp(a) Taskforce has developed a new Call to Action document which sets out recommendations intended to help realise the potential of Lp(a) and address barriers to widespread recognition and acceptance across the NHS. This includes:
- Standardising Lp(a) screening: In the short-term, there is a need to introduce greater standardisation in the screening and measurement of Lp(a), to avoid future challenges as testing becomes more widely adopted in clinical practice.
- Including Lp(a) within CVD risk calculators: Including Lp(a) within the Joint British Societies recommendations on the prevention of Cardiovascular Disease (JBS) and Q-RISK calculators has the potential to improve the accuracy of CVD risk assessments, particularly for patients who are at intermediate risk and have exhibited several clinical predictors of adverse cardiovascular events.
- Including Lp(a) within clinical guidelines: With a growing body of evidence and increasing recognition of Lp(a) as an independent, inherited and causal risk factor for ASCVD, reflected in its inclusion within several prominent international CVD guidelines, the expansion of CG181 to cover Lp(a) would be an important step towards ensuring that patients with elevated Lp(a) levels are identified and receive enhanced cardiovascular risk factor management. This could then inform the introduction of preventative measures to help reduce the significant burden of CVD across the NHS and society.
Commenting on the publication, Chair of the Lp(a) Taskforce and HEART UK Chief Executive Jules Payne said:
“Cardiovascular disease (CVD) continues to place a significant burden on both patients and wider society, with an estimated 7.5 million people living with CVD in the UK. This impact is projected to increase even further over the coming decades due to the effects of an aging population, the prevalence of CVD risk factors and the impact of the Covid-19 backlogs, making it all the more important to consider initiatives that can support prevention and earlier disease identification and management.
We believe that Lp(a) has an important role to play in transforming existing approaches to CVD prevention and care. It is therefore vital that policymakers consider the Taskforce’s recommendations that seek to remove the barriers to widespread recognition of Lp(a) screening across the NHS, in order to support improvements in patient care and outcomes, as well as progress towards national ambitions to make the UK a world-leader in CVD prevention and care.”
Lp(a) is an independent, inherited, and causal risk factor for atherosclerotic cardiovascular disease (ASCVD). It subsequently serves as a vital indicator of individual susceptibility to several related events and conditions including myocardial infarction, stroke, coronary artery disease, peripheral arterial disease, and heart failure.
Approximately 1 in 5 people are estimated to have elevated levels of Lp(a), while it is estimated that elevated Lp(a) concentration is associated with 5% of CVD events.
About the Lp(a) Taskforce
The Lipoprotein(a) Taskforce is a diverse multi-stakeholder group that has been constituted to recognise Lipoprotein(a) – also known as ‘Lp(a)’ – as a key risk factor for atherosclerotic cardiovascular disease (ASCVD) and to raise awareness of the value of screening for Lp(a) in routine clinical practice to improve ASCVD management.
Chaired by HEART UK – the UK’s only charity totally focused on lipids – the Lp(a) Taskforce comprises members from across the lipid and cardiovascular disease community in the UK. This includes representation from the Association of Clinical Biochemistry and Laboratory Medicine, British Cardiovascular Society, British Atherosclerosis Society, Royal College of Pathologists, Royal Society of Medicine, UK NEQAS, WEQAS, Novartis Pharmaceuticals, Amgen, Roche Diagnostics and Randox Biosciences.
The Lp(a) Taskforce is a non-promotional forum and will not advocate for the use of any individual product, medicine, device, or service.
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