Lipoprotein(a) [Lp(a)] is an LDL-like particle bound to apolipoprotein(a), conferring pro-atherogenic and pro-thrombotic properties. Its levels are largely genetically determined and remain stable across life. Strong epidemiologic and genetic evidence supports Lp(a) as an independent and causal risk factor for atherosclerotic cardiovascular disease (ASCVD), including premature coronary artery disease and calcific aortic valve stenosis.
Elevated Lp(a) also contributes to residual cardiovascular risk despite optimal LDL-C lowering. Current consensus statements recommend at least one lifetime measurement of Lp(a), especially in individuals with premature ASCVD, family history of early cardiovascular events, familial hypercholesterolemia, recurrent events despite optimal therapy, or intermediate risk where further stratification may alter management. This is particularly relevant in the…
