{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T22:45:08Z","timestamp":1790635508592,"version":"4.1.0"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,4,7]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Lipoprotein(a) (Lp[a]) can refine atherosclerotic cardiovascular disease risk assessment and guide lipid\u2010lowering therapy intensification (LLTI). However, the association between Lp(a) testing and LLTI across large health systems is not well characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">Using Veterans Affairs electronic health record data, we conducted a retrospective cohort study of veterans undergoing lipid testing from January 1, 2017, to June 30, 2024. We first compared a 1:1 propensity\u2010matched cohort with concurrent low\u2010density lipoprotein cholesterol (LDL\u2010C) and Lp(a) testing with those with LDL\u2010C testing alone. We then compared veterans with elevated versus nonelevated Lp(a) (&gt;50 versus &lt;50\u2009mg\/dL). The primary outcome was LLTI within 12 months, defined as therapy initiation, dose escalation, or addition of another lipid\u2010lowering agent. LDL\u2010C goal attainment (&lt;100\u2009mg\/dL primary prevention; &lt;70\u2009mg\/dL secondary prevention) was assessed within 12\u2009months. Multivariable logistic regression adjusted for sociodemographic and clinical factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">Among 6\u2009941\u2009840 veterans with LDL\u2010C testing, 10\u2009384 (0.1%) underwent Lp(a) testing. The propensity\u2010matched cohort included 20\u2009768 veterans (mean\u00b1SD age, 58.4\u00b115.3\u2009years; 12.4% women; 19.2% Black individuals). Elevated Lp(a) (&gt;50\u2009mg\/dL) was present in 25% (n=2562). Lp(a) testing was associated with greater LLTI (odds ratio [OR], 2.11 [95% CI, 1.95\u20132.29]), LDL\u2010C testing (OR, 1.27 [95% CI, 1.19\u20131.36]), and LDL\u2010C goal attainment (OR, 1.22 [95% CI, 1.12\u20131.33]). Compared with Lp(a) &lt;50\u2009mg\/dL, Lp(a) &gt;50\u2009mg\/dL was associated with increased LLTI (OR, 1.73 [95% CI, 1.55\u20131.94]). Lp(a) &gt;100\u2009mg\/dL was associated with lower LDL\u2010C goal attainment (OR, 0.68 [95% CI, 0.56\u20130.84]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Lp(a) testing was associated with increased LLTI and LDL\u2010C goal attainment. Elevated Lp(a) identified individuals more likely to undergo LLTI, suggesting testing may motivate preventive treatment optimization.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.046519","type":"journal-article","created":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T11:07:37Z","timestamp":1773832057000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Association Between Lipoprotein(a) Testing, Lipid\u2010Lowering Therapy Intensification, and Low\u2010Density Lipoprotein Cholesterol Goal Attainment: Findings From the Veterans Affairs Health System"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3909-154X","authenticated-orcid":false,"given":"Shyon","family":"Parsa","sequence":"first","affiliation":[{"name":"Stanford University 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