Health systems use AI to target patients who may have elevated Lp(a) levels
The Family Heart Foundation research and advocacy organization is working with seven large healthcare systems to comb through electronic medical record (EMR) data and identify patients likely to have elevated lipoprotein(a), or Lp(a), and carry an elevated risk of cardiovascular disease (CVD). This is part of the Flag, Identify, Network and Deliver (FIND) Lp(a) Initiative screening program put together by the Family Heart Foundation with support from Novartis Pharmaceuticals.
The partner health systems include Emory Healthcare, Indiana University Health, John Hopkins University, Medical University of South Carolina, OhioHealth, Stanford Health Care, and University of South Florida. Patients identified in the program as possibly having elevated Lp(a) will be notified so they can come in for Lp(a) testing. If positive, they will be treated more aggressively with lipid lowering drug therapy.
“We are excited to be partnering with the Family Heart Foundation on FIND Lp(a) to help build awareness, increase testing and save lives,” Julie Clary, MD, vice chair for clinical affairs in the department of medicine and clinical lead for the Indiana University Health FIND Lp(a) team, said in a statement. “Elevated Lp(a) affects one in five individuals, but most of those individuals are undiagnosed. Not knowing you have a condition is not the same as not having that condition. Increasing awareness really does save lives.”
Lp(a) is considered a residual risk factor for cardiovascular disease and heart attacks, even when a patient is on optimal preventive medical therapy. It has emerged the past couple years as a major risk factor that the Family Heart Foundation is attempting to shed more light on to boost screening efforts. While there are no specialized drug treatments for Lp(a), studies suggest more aggressive low-density lipoprotein (LDL) drug therapy can help lower Lp(a) levels.
"We can start helping people right now, and it would be meaningful if we can raise more awareness to reduce the burden of CVD," Katherine Wilemon, founder and chief executive officer of the Family Heart Foundation, told Cardiovascular Business. "We are excited that treatments are on the horizon, but even without those treatments we can begin to lower their cholesterol. There are at least three ongoing clinical trials for drugs to treat Lp(a) and they are dramatically dropping Lp(a) levels by 80-90%."
These pharmaceutical companies are already working to raise awareness about the additional cardiac risks Lp(a) poses. They have partnered with the American Heart Association and the Family Heart Foundation to help spread the word to not only cardiologists at conferences and initiatives like FIND Lp(a), but also with primary care physicians at these conferences. There has been an explosion of interest in sessions at major cardiology conferences and vendor booth presentations at these meetings. This includes Lp(a) blood testing for attendees at these meetings, where lines at the AHA and ACC have been hundreds of people long. While Lp(a) has been studied since the 1960s, recent research showing its impact on CVD and the positive results so far for the new drugs have helped elevated the interest.
Wilemon said anonymized data collected from 300 million patients by the Family Heart Foundation show about 20% of the population has elevated Lp(a). This data was used to train the artificial intelligence algorithm now being used by health systems in the FIND Lp(a) Initiative.
The initiative has already identified some issues with AI-based screening. For example, patients are less likely to come in for screening if they receive an alert from their patient portal. Wilemon said they have found that phone calls worked much better at getting patients to come in.
Family Heart Foundation says Lp(a) treatment could be a paradigm shift in care
Wilemon said testing and treating patients for Lp(a) could make a big impact for decreasing mortality and to close the loop in CVD prevention. She said the FIND Lp(a) Initiative is really a quality improvement effort in CVD care.
“While elevated Lp(a) is a common and serious risk factor for atherosclerotic cardiovascular disease, fewer than 5% of individuals living with it are aware. The FIND Lp(a) initiative seeks to close this gap in diagnosis and appropriate care,” Wilemon explained. “The Family Heart Foundation and our health system partners are committed to leading the way in addressing elevated Lp(a) as the most common, yet under-diagnosed risk factor for early cardiovascular disease.”
The mission of the non-profit Family Heart Foundation is to save generations of families from heart disease through timely identification and improved care of familial hypercholesterolemia (FH) and elevated Lp(a). The group works through research, advocacy and education. It also works directly with patients to empower families to navigate their own health.
Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: [email protected]