Abstract WP114: Increasing Rates of Lipoprotein(a) Testing in Young Ischemic Stroke Patients from 2015-2024: An Analysis of 300 Million Individuals

Background: Lipoprotein(a) [Lp(a)] is a genetically determined biomarker associated with increased risk of myocardial infarction and stroke. Approximately 20-25% of patients aged ≤60 who have had an ischemic cerebrovascular accident (CVA) have an elevated Lp(a) >50 mg/dL (>125 nmol/L). However, Lp(a) testing remains underutilized in this population, and limited data on national testing trends are available. Methods: This study includes data from Epic Cosmos, a nationwide, de-identified electronic health record dataset comprising over 300 million patients, between January 1, 2015, to December 31, 2024. We evaluated the number of young ischemic stroke patients, defined as age ≤60 with history of an ischemic CVA, who had undergone Lp(a) testing, the testing rate per annual young ischemic stroke patients, geographical variation, and percentages of patients tested stratified by age, sex, ethnicity, race, and diagnosis of coronary artery disease (CAD). Results: From 2015 to 2024, out of a total of 188,305 distinct young ischemic stroke patients, 9,226 (4.90%) underwent Lp(a) testing. Additionally, the annual number of tested patients increased significantly from 179 in 2015 to 1,992 in 2024 (χ 2 test, p