Who to test? 11 Lp(a) and PAD Toolkit: Emerging Diagnosis and Management How should one measure Lp(a)?12 2018 Guideline on the Management of Blood Cholesterol states the relative indications for measurement are family history of premature ASCVD or personal history of ASCVD not explained by major risk factors.14, 15, 16, 17 Lp(a) should be measured with: Those with borderline ASCVD risk to aid in discussion of risk modification therapies Family or personal history of high Lp(a), heart disease, or premature cardiovascular disease Diagnosis of familial hypercholesterolemia (FH) - an inherited condition 18 An isoform-insensitive assay Assay that is traceable to the internationally accepted calibrator (World Health Organization/International Federation of Clinical Chemistry Reference Material SRM-2B) Assay that is reported in nanomoles per liter (nmol/l), when possible. ? Raising Awareness of Lp(a) Once an individual’s Lp(a) levels are tested, do they need to be retested? Although levels are generally stable over time, the levels can vary between labs or may increase after development of certain medical conditions, may decrease after treatment, and may otherwise vary. It may also be helpful to verify results with an outside lab before initiating therapies. If measurements are not uniformly calibrated, one cannot compare measurements generated by different assays.
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