Expert Warns: Systematic Lp(a) Testing Could Prevent 12,000 Heart Attacks and Strokes in Austria

A prominent researcher from Tyrol, Florian Kronenberg, has called for the inclusion of routine Lipoprotein(a) testing in Austria's national health strategy. The Lp(a) marker is critical in assessing the risk of heart attacks and strokes. Kronenberg asserts that adopting this measure could lead to savings of over half a billion euros in healthcare costs while preventing approximately 12,000 incidents of heart attacks and strokes annually.

Kronenberg, who heads the Institute for Genetic Epidemiology at the Medical University of Innsbruck, played a significant role as the chair of the International Lp(a) Taskforce during the recent Global Summit on Elevated Lp(a) held in Brussels on March 24-25. The summit successfully convened leading experts and EU parliamentarians alongside organizations like the World Health Organization (WHO). During the event, initial cost-effectiveness analyses regarding Lp(a) testing for individuals aged 40 to 69 were presented, demonstrating the financial viability of systematic testing despite the absence of available medication to lower Lp(a) levels.

While Kronenberg emphasized the importance of raising awareness about Lp(a) testing without inducing fear, he noted that the Medical University of Innsbruck has been recommending such tests since 1995. Although guidelines in 2010 initially limited testing to high-risk groups, recommendations have since expanded. Yet, many countries, including Austria, have yet to incorporate these tests into their health plans.

The cost-effectiveness analyses were conducted by esteemed expert Zanfina Ademi from Melbourne, collaborating with the International Lp(a) Taskforce. The studies calculated the potential reduction in heart attacks and strokes if all Austrians aged 40 to 69 underwent testing and those with elevated Lp(a) levels received more intensive treatment. Kronenberg pointed out that while there are currently no direct treatments available to reduce Lp(a), effective medications exist for lowering LDL cholesterol, managing blood pressure, and promoting lifestyle changes. These interventions could lead to a significant decrease in long-term healthcare expenditures, resulting from fewer rehabilitation treatments and reduced early retirement due to illness.

Austria is in a favorable position compared to other countries regarding Lp(a) testing, as individuals can have a one-time test covered by health insurance. However, many healthcare providers do not routinely offer this test, highlighting the necessity for increased education and awareness among medical professionals.

Kronenberg reiterated that elevated Lp(a) levels are a significant risk factor for cardiovascular diseases. However, he cautioned that Lp(a) levels should not be viewed in isolation; elevated levels combined with normal LDL cholesterol may present a lower risk than average. In Austria, approximately one in three individuals dies from cardiovascular disease. For those with multiple risk factors and a notably high Lp(a) level, the likelihood of experiencing a heart attack or stroke during their lifetime rises dramatically from 25% to 68%.

Lp(a), a genetically determined blood fat, increases the risk of heart attacks and strokes. While there are no existing medications specifically targeting Lp(a) reduction, Kronenberg advocates for its measurement. The cost-effectiveness analyses have compellingly illustrated the benefits of identifying at-risk individuals and managing their other risk factors more intensively.

Significantly, several pharmaceutical companies are currently developing treatments aimed at reducing Lp(a), with some in Phase III clinical trials. Preliminary studies involving up to 30,000 participants have shown that Lp(a) levels can potentially be decreased by as much as 95%. The implications of whether these reductions will translate into lower rates of heart attacks and strokes are expected to be clearer within the next year, which could be a vital advancement in cardiovascular medicine.