Does routine measurement of lipoprotein(a) in a UK lipid clinic alter management in the absence of Lp(a)-specific therapy?

BACKGROUND: Elevated lipoprotein(a) [Lp(a)] is an inherited, causal risk factor for atherosclerotic cardiovascular disease (ASCVD). Despite guideline endorsement, its measurement is inconsistently adopted within the UK healthcare setting. Understanding whether identifying raised Lp(a) alters real-world management and lipid outcomes is key to guiding policy. OBJECTIVE: To evaluate the distribution of Lp(a) levels in a UK lipid clinic, quantify management changes across clinically relevant thresholds and explore the relationship between Lp(a) and final non-HDL-cholesterol (non-HDL-C) attainment. METHODS: This retrospective observational study included 337 patients attending a specialist lipid clinic. Demographics, atherosclerotic cardiovascular (ASCVD) disease status, HEART UK Lp(a) testing criteria, management actions, and final non-HDL-C values were analyzed. Lp(a) concentrations were initially grouped into five descriptive categories (