Analysis of lipoprotein (a) determination in a selection of Spanish Clinical Laboratories. Batary study

Abstract

INTRODUCTION: Lipoprotein a is considered an independent factor of atherosclerotic cardiovascular disease with high prevalence, but the availability of real and updated data in Spain as well as determination protocols are limited. MAIN OBJECTIVE: Analyze the current state of the pre-analytical, analytical and post-analytical process of Lp (a) and assess the relationship with other variables. MATERIAL AND METHOD: Retrospective, observational, multicenter, anonymized study carried out in 2022 by survey of clinical laboratories. RESULTS: 21,926 determinations were obtained corresponding to 49 Laboratories. The values obtained were: Lp(a)>30mg/dl=46.87%, Lp(a)>50mg/dl 35.31%, Lp(a)>70mg/dl=26.8% Lp(a)>90mg/dl=19.3% with predominance of superiority in female gender in all established cut-off points. Almost 30% of primary care doctors do not have access to their application. 56.9% do not have a rejection criterion. 70.6% do not have protocols for its determination. There are two predominant analytical techniques, Immunophelometry (40%) and immunoturbidimetry (60%), 24% use nmon/L, 68% mg/dL and 8% report both. CONCLUSIONS: There is a low number of patients who have Lp(a) measured and of them the percentage of patients according to risk cut-off points are higher than those described. There is a lack of uniformity in pre-analytical, analytical and post-analytical processes in which it is necessary to work in a multidisciplinary manner to avoid future cardiovascular events.