{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T02:08:38Z","timestamp":1787882918492,"version":"build-2784847793"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T00:00:00Z","timestamp":1720483200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Lipoprotein(a) [Lp(a)] is a genetically determined risk factor for atherosclerotic cardiovascular disease (CVD). Limited data are available on Lp(a) testing from the Middle-East region. Therefore, we aim to evaluate the utilization and yield of Lp(a) testing over time and characterize CVD profiles of patients with abnormal Lp(a) tasting at a single-quaternary-care center in the United Arab Emirates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Unique Lp(a) tests conducted between 07\/2017 and 10-2023 were included. Overtime trends in Lp(a) test utilization and abnormal Lp(a) [defined as Lp(a)\u2009&amp;gt;\u2009125\u2005nmol\/L] test findings were described. CVD rates in patients with abnormal Lp(a) were compared to those with Lp(a)\u2009\u2264\u2009125\u2005nmol\/L using appropriate methods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In our center, 0.95% of the patients (<jats:italic>n<\/jats:italic>\u2009=\u20095,677) had their Lp(a) measured, with a median level of 32 [11\u201382] nmol\/L. Lp(a) was abnormal in 15.9% of the tests. Over the years 2018\u20132022, there was a 109% increase in Lp(a) testing, with concomitant up-trends in findings of abnormal Lp(a) (11.8% to 16.4%, <jats:italic>P<\/jats:italic>\u2009=\u20090.02). Compared to patients with Lp(a)\u2009\u2264\u2009125\u2005nmol\/I, those with abnormal Lp(a) had higher rates of any prevalent CVD (34% vs. 25.1%, <jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.001), CAD (25.6% vs. 17.7%, <jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.001), HF (6.5% vs. 3.8%, <jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.001), and stroke (7.1% vs. 4.4%, <jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Almost one in six patients tested for Lp(a) had abnormally elevated Lp(a), and CVD was prevalent in one-third of the patients who tested abnormal for Lp(a). The study highlights the growing awareness of the relevance of Lp(a) for CVD risk stratification and prevention.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2024.1439013","type":"journal-article","created":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T04:42:00Z","timestamp":1720500120000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":8,"title":["Trends and findings of lipoprotein(a) testing and associated cardiovascular disease profiles: a large single-center study from the Middle East-Gulf region"],"prefix":"10.3389","volume":"11","author":[{"given":"Yosef","family":"Manla","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laila","family":"AbdelWareth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronney","family":"Shantouf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yazan","family":"Aljabery","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terrence Lee","family":"St John","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hani","family":"Sabbour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bartlomiej","family":"Piechowski-Jozwiak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wael","family":"Almahmeed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,7,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"374","DOI":"10.1016\/j.jacl.2019.04.010","article-title":"Use of lipoprotein (a) in clinical practice: a biomarker whose time has come. A scientific statement from the national lipid association","volume":"13","author":"Wilson","year":"2019","journal-title":"J Clin Lipidol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajpc.2024.100651","article-title":"High lipoprotein (a): actionable strategies for risk assessment and mitigation","volume":"18","author":"Reyes-Soffer","year":"2024","journal-title":"Am J Prev Cardiol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"2301","DOI":"10.1093\/clinchem\/44.11.2301","article-title":"Lipoprotein (a) as a risk factor for ischemic heart disease: metaanalysis of prospective studies","volume":"44","author":"Craig","year":"1998","journal-title":"Clin Chem"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1082","DOI":"10.1161\/01.CIR.102.10.1082","article-title":"Lipoprotein (a) and coronary heart disease: meta-analysis of prospective studies","volume":"102","author":"Danesh","year":"2000","journal-title":"Circulation"},{"key":"B5","doi-asserted-by":"publisher","first-page":"496","DOI":"10.1016\/j.atherosclerosis.2015.08.021","article-title":"Lipoprotein (a) as a risk factor for ischemic stroke: a meta-analysis","volume":"242","author":"Nave","year":"2015","journal-title":"Atherosclerosis"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1732","DOI":"10.1161\/ATVBAHA.112.248765","article-title":"Genetic evidence that lipoprotein (a) associates with atherosclerotic stenosis rather than venous thrombosis","volume":"32","author":"Kamstrup","year":"2012","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1016\/j.jchf.2015.08.006","article-title":"Elevated lipoprotein (a) levels, LPA risk genotypes, and increased risk of heart failure in the general population","volume":"4","author":"Kamstrup","year":"2016","journal-title":"JACC Heart Fail"},{"key":"B8","doi-asserted-by":"publisher","first-page":"2760","DOI":"10.1093\/eurheartj\/ehy902","article-title":"High lipoprotein (a) and high risk of mortality","volume":"40","author":"Langsted","year":"2019","journal-title":"Eur Heart J"},{"key":"B9","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1016\/j.jacc.2019.03.524","article-title":"Elevated lipoprotein (a) and risk of ischemic stroke","volume":"74","author":"Langsted","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1426","DOI":"10.1161\/CIR.0000000000000312","article-title":"Further evolution of the ACC\/AHA clinical practice guideline recommendation classification system: a report of the American College of Cardiology\/American Heart Association Task Force on clinical practice guidelines","volume":"133","author":"Halperin","year":"2016","journal-title":"Circulation"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2023.102022","article-title":"The burden of metabolic risk factors in north Africa and the Middle East, 1990\u20132019: findings from the global burden of disease study","volume":"60","author":"Malekpour","year":"2023","journal-title":"EClinicalMedicine"},{"key":"B12","doi-asserted-by":"publisher","first-page":"543","DOI":"10.1007\/s11883-023-01126-x","article-title":"The pandemic of coronary heart disease in the Middle East and north Africa: what clinicians need to know","volume":"25","author":"Manla","year":"2023","journal-title":"Curr Atheroscler Rep"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpcardiol.2024.102564","article-title":"Advanced heart failure therapies in the eastern Mediterranean region: current status, challenges, and future directions","volume":"49","author":"Bader","year":"2024","journal-title":"Curr Probl Cardiol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpcardiol.2023.102341","article-title":"Cardiovascular disease burden in the Middle East and North Africa region","volume":"49","author":"Alhuneafat","year":"2023","journal-title":"Curr Probl Cardiol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2023.102034","article-title":"Trends in the burden and determinants of hypertensive heart disease in the eastern Mediterranean region, 1990\u20132019: an analysis of the global burden of disease study 2019","volume":"60","author":"Mansouri","year":"2023","journal-title":"EClinicalMedicine"},{"key":"B16","doi-asserted-by":"publisher","first-page":"e0290286","DOI":"10.1371\/journal.pone.0290286","article-title":"The burden of ischemic heart disease and the epidemiologic transition in the eastern Mediterranean region: 1990\u20132019","volume":"18","author":"Sadeghi","year":"2023","journal-title":"PLoS One"},{"key":"B17","doi-asserted-by":"publisher","first-page":"2350","DOI":"10.1016\/j.jacc.2023.11.007","article-title":"Global burden of cardiovascular diseases and risks, 1990\u20132022","volume":"82","author":"Mensah","year":"2023","journal-title":"J Am Coll Cardiol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1472","DOI":"10.1161\/CIRCULATIONAHA.118.034311","article-title":"Lipoprotein (a) levels and the risk of myocardial infarction among 7 ethnic groups","volume":"139","author":"Par\u00e9","year":"2019","journal-title":"Circulation"},{"key":"B19","doi-asserted-by":"publisher","first-page":"3925","DOI":"10.1093\/eurheartj\/ehac361","article-title":"Lipoprotein (a) in atherosclerotic cardiovascular disease and aortic stenosis: a European atherosclerosis society consensus statement","volume":"43","author":"Kronenberg","year":"2022","journal-title":"Eur Heart J"},{"key":"B20","doi-asserted-by":"publisher","first-page":"e308","DOI":"10.1016\/j.jacl.2024.03.001","article-title":"A focused update to the 2019 NLA scientific statement on use of lipoprotein (a) in clinical practice","volume":"18","author":"Koschinsky","year":"2024","journal-title":"J Clin Lipidol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"e1082","DOI":"10.1161\/CIR.0000000000001172","article-title":"2018 AHA\/ACC\/AACVPR\/AAPA\/ABC\/ACPM\/ADA\/AGS\/APhA\/ASPC\/NLA\/PCNA guideline on the management of blood cholesterol: a report of the American College of Cardiology\/American Heart Association Task Force on clinical practice guidelines","volume":"139","author":"Grundy","year":"2019","journal-title":"Circulation"},{"key":"B22","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1093\/eurheartj\/ehz455","article-title":"2019 ESC\/EAS guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk: the task force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and European atherosclerosis society (EAS)","volume":"41","author":"Mach","year":"2020","journal-title":"Eur Heart J"},{"key":"B23","doi-asserted-by":"publisher","first-page":"1129","DOI":"10.1016\/j.cjca.2021.03.016","article-title":"2021 Canadian cardiovascular society guidelines for the management of dyslipidemia for the prevention of cardiovascular disease in adults","volume":"37","author":"Pearson","year":"2021","journal-title":"Can J Cardiol"},{"key":"B24","doi-asserted-by":"publisher","first-page":"1196","DOI":"10.4158\/CS-2020-0490","article-title":"Consensus statement by the American association of clinical endocrinologists and American College of endocrinology on the management of dyslipidemia and prevention of cardiovascular disease algorithm\u20132020 executive summary","volume":"26","author":"Handelsman","year":"2020","journal-title":"Endocr Pract"},{"key":"B25","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1016\/j.atherosclerosis.2023.01.014","article-title":"Trends and consequences of lipoprotein (a) testing: cross-sectional and longitudinal health insurance claims database analyses","volume":"367","author":"St\u00fcrzebecher","year":"2023","journal-title":"Atherosclerosis"},{"key":"B26","doi-asserted-by":"publisher","first-page":"e031255","DOI":"10.1161\/JAHA.123.031255","article-title":"Lipoprotein (a) testing trends in a large academic health system in the United States","volume":"12","author":"Bhatia","year":"2023","journal-title":"J Am Heart Assoc"},{"key":"B27","doi-asserted-by":"publisher","first-page":"100478","DOI":"10.1016\/j.ajpc.2023.100478","article-title":"Contemporary patterns of lipoprotein (a) testing and associated clinical care and outcomes","volume":"14","author":"Kelsey","year":"2023","journal-title":"Am J Prev Cardiol"},{"key":"B28","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1016\/j.atherosclerosis.2022.01.022","article-title":"Trends in testing and prevalence of elevated lp (a) among patients with aortic valve stenosis","volume":"349","author":"Bhatia","year":"2022","journal-title":"Atherosclerosis"},{"key":"B29","doi-asserted-by":"publisher","first-page":"e331","DOI":"10.1093\/eurjpc\/zwac124","article-title":"Lipoprotein (a) testing in clinical practice: real-life data from a large healthcare provider","volume":"29","author":"Zafrir","year":"2022","journal-title":"Eur J Prev Cardiol"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2024.1439013\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T04:42:03Z","timestamp":1720500123000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2024.1439013\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,9]]},"references-count":29,"alternative-id":["10.3389\/fcvm.2024.1439013"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2024.1439013","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,9]]},"article-number":"1439013"}}