Abstract 14669: Prevalence of Elevated Lp(a) Levels in 629,858 Subjects From a Referral Laboratory Population in the United States

Abstract

Background: Elevated Lp(a) is now accepted as a causal, independent risk factor for cardiovascular disease. Data suggest that ~20% of subjects living in the Copenhagen area have elevated Lp(a) levels (>50 mg/dL. Lp(a) <50 mg/dL has been recommended as a desirable level, but similar large datasets in varied populations have not been available from other countries. Methods: We analyzed fasting Lp(a) in 629,858 subjects from the large referral dataset from Health Diagnostic Laboratory measured in years 2010 to 2014 to assess prevalence of elevated Lp(a). Lp(a) mass levels were measured by immunoturbidometric assay and expressed as mg/dL. Results: Median age of the subjects was 56, and 53.7% were female. Lp(a) levels were skewed rightward (Figure). The mean±SD levels were 31±38 mg/dL and median (IQR) levels were 15 (7-43) mg/dL, with range 0-571 mg/dL. Females had higher median (IQR) Lp(a) levels than males [16 (8-47) vs. 13 (6-38), p<0.0001]. Lp(a) percentile levels at 75%, 80%, 90%, 95% and 99% were >43 mg/dL, >55 mg/dL, >85 mg/dL, >109 mg/dL, and >169 mg/dL, respectively. Lp(a) levels >30 mg/dL and >50 mg/dL were present in 31.8% and 21.8% of subjects, respectively Conclusion: This is the largest database to assess the distribution of Lp(a). Lp(a) levels >30 and >50 mg/dL were common, constituting 31.8% and 21.8% of this referral laboratory population, and are consistent with the Copenhagen data. These data will help to define new global guidelines and therapeutic targets for new Lp(a) lowering therapies, such as antisense oligonucleotides directed to apo(a).