Abstract 4366858: Integrating Lipoprotein(a) and Albuminuria Screening into Cardiovascular Primary Prevention: Early Outcomes from the CardioPrevent Program

Abstract

Background: Lipoprotein(a) [Lp(a)] and urine albumin-to-creatinine ratio (UACR) are increasingly recognized as important biomarkers in cardiovascular risk assessment. Elevated Lp(a) is a genetically determined, independent risk factor for atherosclerotic cardiovascular disease (ASCVD), while elevated UACR reflects early renal and endothelial dysfunction—both associated with increased cardiovascular events. Despite their clinical significance, these markers are not routinely screened in the primary prevention setting. The CardioPrevent program is a comprehensive cardiovascular prevention initiative designed for all individuals at risk of developing cardiovascular disease, including those with traditional risk factors as well as postpartum individuals who experienced pregnancy related complications such as pre-eclampsia, gestational diabetes, etc. Originally launched as a health coaching initiative focused on lifestyle modification, we evolved the program in 2025 to include a Cardiometabolic-Prevention Clinic, enabling us to provide medical management and advanced risk stratification for high-risk individuals. Methods: In January 2025, we implemented a medical directive to routinely screen all new patients for Lp(a) and UACR, regardless of whether they had a primary care provider. This initiative was especially impactful for postpartum individuals with a history of pregnancy complications—who are at increased long-term cardiovascular risk but often lack consistent follow-up care. Results: Since the new directive’s implementation, 19% of patients were identified with elevated Lp(a) and 4% with elevated UACR—individuals who would have otherwise gone undetected through standard care pathways. A proportion of these were postpartum patients without access to a physician or nurse practitioner, highlighting a critical gap in care that our clinic is helping to bridge. Conclusion: By integrating Lp(a) and UACR screening into our preventive care model, we uncovered a significant burden of unrecognized cardiovascular risk. The addition of the Cardiometabolic-Prevention Clinic has allowed us to proactively manage high-risk individuals, particularly in underserved populations. These findings support broader adoption of such screening strategies in primary prevention, especially for postpartum individuals with prior pregnancy complications.