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Lipoprotein(a)—When to Screen and How to Treat

  • Lipids (M. Shapiro, Section Editor)
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Current Cardiovascular Risk Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Lipoprotein(a) (Lp(a)) is a proinflammatory and atherogenic molecule that is emerging as an important biomarker of cardiovascular (CV) risk. It has been implicated in the pathogenesis of both atherosclerotic cardiovascular disease (ASCVD) and aortic valve stenosis. An estimated 10–30% of the global population has elevated Lp(a) levels. Screening for and treating elevated Lp(a) represents an opportunity to reduce risk for adverse CV events.

Recent Findings

Current guidelines from the American College of Cardiology and National Lipid Association recommend Lp(a) testing in high-risk individuals. The European Atherosclerosis Society takes a stronger stance, recommending once in a lifetime lipoprotein(a) testing across the general population. Few recommendations currently exist regarding treatment of elevated lipoprotein(a).

Summary

Because elevated Lp(a) is an independent risk factor for cardiovascular disease, further screening and treatment is necessary. Ongoing clinical trials with RNA based therapeutics such as antisense oligonucleotides and small interfering RNA show great promise for lowering Lp(a). More data is needed to demonstrate improved cardiovascular outcomes from Lp(a) reduction. Lp(a) should be incorporated into clinical practice as a useful biomarker to guide decisions about ASCVD risk and treatment.

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  1. University of California, San Diego, 9300 Campus Point Drive, La Jolla, CA, 92037, USA

    Neeja Patel, Nikita Mittal, Parnia Abolhassan Choubdar & Pam R. Taub

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  1. Neeja Patel
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Neeja Patel, Nikita Mittal, and Parnia Abolhassan Choubdar, MD declare they have no conflict of interest. Pam R Taub, MD is a consultant for Novartis and Amgen outside the submitted work.

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Patel, N., Mittal, N., Choubdar, P.A. et al. Lipoprotein(a)—When to Screen and How to Treat. Curr Cardiovasc Risk Rep 16, 111–120 (2022). https://doi.org/10.1007/s12170-022-00698-8

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