Design and initial results of the Canadian lipoprotein(a) registry
Notice bibliographique
Résumé
Abstract Background Lipoprotein(a) [Lp(a)] is a genetically determined independent risk factor for atherosclerotic cardiovascular disease (ASCVD). Multiple guidelines recommend universal testing of Lp(a) once in an individual’s lifetime, and intensification of risk factor management in individuals with elevated Lp(a). However, there are limited data about how Lp(a) levels are being used in clinical practice. Purpose The Canadian Lp(a) Registry is designed to characterize the risk factors, management, and outcomes of patients with elevated Lp(a). Here we report the design and preliminary characteristics of patients enrolled in the registry. Methods The Canadian Lp(a) Registry is a prospective, longitudinal observational study including participating sites throughout Canada. Enrolment began in June 2024 and the inclusion criterion is Lp(a) ≥100 nmol/L (50 mg/dL). Data are collected at baseline and at annual follow-up, and include patient demographics, risk factors, lab values, imaging tests, medications, and cardiovascular outcomes. Results A total of 93 patients were enrolled in the registry as of February 2025, 47 (50.5%) of whom were male (Table 1). The mean age was 57.1±13.0 years. The median Lp(a) level was 225 (IQR 186-346) nmol/L. The mean number of Lp(a) measurements per patient was 2.0±1, with 48 (51.6%) having more than 1 lifetime measurement of Lp(a). Probable or definite familial hypercholesterolemia was present in 36.6%. The mean low-density lipoprotein cholesterol (LDL) was 2.31 ± 1.58, with most patients (79.6%) being on lipid-lowering therapies. These included statins (75.3%), ezetimibe (47.3%), and PCSK9 inhibitors (34.4%). Many patients (53.8%) were taking multiple lipid-lowering therapies. Cardiovascular disease at the time of enrollment in the registry included 18 (19.4%) patients with prior myocardial infarction, 31 (33.3%) with prior coronary revascularization, and 4 (4.3%) who had a previous stroke or transient ischemic attack. A history of severe aortic stenosis was present in 4 (4.3%) patients. Conclusions The Canadian Lp(a) Registry is a prospective observational study designed to generate real world evidence regarding the clinical management and cardiovascular outcomes for patients with elevated Lp(a). Preliminary results from the baseline characteristics of the registry indicate this is a high-risk population, with many patients having pre-existing ASCVD or familial hypercholesterolemia. However, 1 in 5 patients with elevated Lp(a) were not taking any lipid-lowering therapy at the time of enrolment. Repeat testing of Lp(a) levels was common and could suggest uncertainty among care providers about how to use Lp(a) testing. Future results from this registry will help improve understanding of how Lp(a) levels are being used as part of routine clinical practice and to identify opportunities to optimize the quality of care of this population.Table 1
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,013 | 0,018 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,003 | 0,007 |
| Études des sciences et des technologies | 0,005 | 0,001 |
| Communication savante | 0,003 | 0,001 |
| Science ouverte | 0,003 | 0,003 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,007 | 0,002 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».