Patient perceptions on lipoprotein(a) testing and treatment for secondary prevention of cardiovascular disease: results from the INTERASPIRE study in seven countries across five World Health Organization regions

Abstract

AIMS: Lipoprotein(a) [Lp(a)], an inherited lipoprotein, was measured in patients with coronary disease participating in the INTERASPIRE study. The aim of this study was to survey patients' knowledge and perceptions of cardiovascular risk and their views on Lp(a) testing, consequences, and treatment. METHODS AND RESULTS: In seven participating countries, recruited patients were divided into those with elevated Lp(a) [≥ 50 mg/dL (≥115 mmol/L)] and those with normal levels. In the elevated group, patients were given an educational leaflet about Lp(a), advised to see their physician and subsequently attended a telephone interview that included study-specific questionnaires assessing knowledge, risk perception, and interest in and acceptability of Lp(a) testing. A random sample of patients with normal Lp(a) were interviewed in the same way. Eight hundred fifty-six patients were interviewed, 523 (22.6% female) with normal Lp(a) and 333 (29.1% female) with elevated Lp(a). Knowledge of cardiovascular disease (CVD) was similar in both groups with a score of 62.1% in normal Lp(a) and 59.6 in elevated Lp(a) P = 0.073. Knowledge of Lp(a) and its management in both groups was poor. Patients with elevated Lp(a) were worried by their result but found testing acceptable and appreciated the benefits. They were motivated to reduce their risk of CVD despite the absence of medical therapies and were eager to receive advice. CONCLUSION: Health professionals working in CVD care should be aware of the need to investigate patients with coronary disease for Lp(a) and be equipped to give advice on how to reduce overall cardiovascular risk especially given the absence of licenced therapies to treat Lp(a).