Lp(a) and The Clinical Laboratory: Guidance for Measuring & Interpretation of Lp(a) and Some Common Lab Misconceptions
Leslie J. Donato, Ph.D., DABCC
Co-Director, Cardiovascular Laboratory Medicine; Hospital Clinical Laboratory and Point of Care Testing, Department of Laboratory Medicine and Pathology, Mayo Clinic (Rochester, MN, US)
Jing Cao, PhD, DABCC, FAACC
Associate Professor of University of Texas Southwestern Medical Center;
NACCCA president of 2019-2020; Chair, AACC Lipoproteins and Vascular Diseases Division
Lipoprotein(a) has been widely recognized as an independent risk factor for cardiovascular disease in international guidelines but measuring its concentration accurately remains a challenge for the clinical laboratory.
The wide size heterogeneity of Lp(a) size within the population leads to a major challenge in accurately measuring lipoprotein(a) concentrations and necessitates the use of appropriate methodologies, calilbrators, standardization of calibration protocols, assay traceability, and reporting units.
The concentration of Lp(a) particles in circulation, while most conventionally used, is not the only laboratory assessment of this lipoprotein that can be measured.
The cholesterol within Lp(a) can contribute significantly to LDL-C and can cause diagnostic confusion when assessing the etiology of a lipid disorder.
To explain the applications of lipoprotein(a) measurement in managing cardiovascular disease risk.
To discuss guidance to clinical laboratories regarding choice of appropriate assays.
To understand the contribution of the cholesterol within lipoprotein(a) to the standard lipid panel results.