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Alex inherited more than just his smile. She inherited elevated Lp(a)* - increasing her risk for another heart attack.

Elevated Lp(a) is a unique and genetically determined condition that can increase risk for ASCVD—in patients younger than you might expect1,2,8-11

Watch the video to see how Lp(a) testing can uncover a potential CV risk in patients with premature ASCVD (age <55 years in men, age <65 years in women)—and their family members.7,9

Despite its clinical significance, Lp(a) levels are often not measured as part of a standard CV risk assessment7,12,13

Lp(a) is prothrombotic, proinflammatory, and about 6-fold more atherogenic than LDL-C per particle basis. Clinical relevance is unknown.

Clinical relevance is unknown.

Atherogenicity was defined as the difference in coronary heart disease (CHD) risk per unit difference in Lp(a) or LDL particle number (molar concentration). This study was based on the UK Biobank population (>502,000 UK residents) who were predominately of European ancestry. The generalizability of the findings was tested in a replication cohort: the CARDIoGRAMplusC4D (Coronary ARtery DIsease Genome wide Replication and Meta-analysis [CARDIoGRAM] plus The Coronary Artery Disease Genetics) data set. Study did not differentiate between subjects with or without CHD at baseline. Analysis focused on the ApoB component of Lp(a).15

  • Lp(a) levels are ~90% genetically determined, typically established by 5 years of age, relatively consistent over time, and generally not affected by diet or lifestyle1,2,9,16

  • In one study, the higher a person's Lp(a) level, the higher their risk for a lifetime CV event16

  • The CV risk from elevated Lp(a) is independent of other risk factors2,5,7,17

Uncovering elevated Lp(a) can provide a deeper understanding of cardiovascular risk for your patients with premature ASCVD—and for their family members7,9

A surprising portion of patients with premature ASCVD may have elevated Lp(a)18

Professional organizations are recognizing the emerging importance of Lp(a) testing to inform next steps—including for your patients with premature ASCVD7,9,19-21

An elevated Lp(a) test result is actionable today by helping you better manage your patients' overall CV risk7

ASCVD, atherosclerotic cardiovascular disease; CV, cardiovascular; CVD, cardiovascular disease; LDL, low-density lipoprotein; Lp(a), Lipoprotein (a).

References: 1. Tsimikas S. A test in context: lipoprotein(a): diagnosis, prognosis, controversies, and emerging therapies. J Am Coll Cardiol. 2017;69(6):692-711. 2. Reyes-Soffer G, Ginsburg H, Berglund L, et al. Lipoprotein(a): a genetically determined, causal, and prevalent risk factor for atherosclerotic cardiovascular disease: a scientific statement from the American Heart Association. Arterioscler Thromb Vasc Biol. 2022;42(1):e48-e60. 3. MacDougall DE, Tybjærg-Hansen A, Knowles JW, et al. Lipoprotein(a) and recurrent atherosclerotic cardiovascular events: the US Family Heart Database. Eur Heart J. Published online May 7, 2025. 4. Welsh P, Zabiby AA, Byrne H, et al. Elevated lipoprotein(a) increases risk of subsequent major adverse cardiovascular events (MACE) and coronary revascularisation in incident ASCVD patients: a cohort study from the UK Biobank. Atherosclerosis. 2024;389:1-8. 5. Madsen CM, Kamstrup PR, Langsted A, et al. Lipoprotein(a)-lowering by 50 mg/dL (105 nmol/L) may be needed to reduce cardiovascular disease 20% in secondary prevention. Arterioscler Thromb Vasc Biol. 2020;40:255-266. 6. Berman AN, Biery DW, Besser SA, et al. Lipoprotein(a) and major adverse cardiovascular events in patients with or without baseline atherosclerotic cardiovascular disease. J Am Coll Cardiol. 2024;83(9):873-886. doi:10.1016/j.jacc.2023.12.031. 7. Koschinsky ML, Bajaj A, Boffa MB, et al. A focused update to the 2019 NLA scientific statement on use of lipoprotein(a) in clinical practice. J Clin Lipidol. 2024;18(3):e308-e319. 8. Jawi MM, Frohlich J, Chan SY. Lipoprotein(a) the insurgent: a new insight into the structure, function, metabolism, pathogenicity, and medications affecting lipoprotein(a) molecule. J Lipids. 2020 Feb 1:2020 3491764. 9. Wilson DP, Jacobson TA, Jones PH, et al. Use of lipoprotein(a) in clinical practice: a biomarker whose time has come. A scientific statement from the National Lipid Association. J Clin Lipidol. 2019;13(3):374-392. 10. Rallidis LS, Pavlakis G, Foscolou A, et al. High levels of lipoprotein (a) and premature acute coronary syndrome. Atherosclerosis. 2018;269:29-34. 11. Tian X, Zhang N, Tse G, et al. Association between lipoprotein(a) and premature atherosclerotic cardiovascular disease: a systematic review and meta-analysis. Eur Heart J Open. 2024;4(3):oeae031. 12. Bhatia HS, Hurst S, Desai P, et al. Lipoprotein(a) testing trends in a large academic health system in the United States. J Am Heart Assoc. 2023;12(18):e031255. 13. Shah NP, Mulder H, Lydon E, et al. Lipoprotein (a) Testing in Patients With Atherosclerotic Cardiovascular Disease in 5 Large US Health Systems. J Am Heart Assoc. 2024;13(21):e035610. 14. Tsimikas S, Fazio S, Ferdinand K, et al. NHLBI Working Group recommendations to reduce lipoprotein(a)-mediated risk of cardiovascular disease and aortic stenosis. J Am Coll Cardiol. 2018;71(2):177-192. 15. Björnson E, Adiels M, Taskinen MR, et al. Lipoprotein(a) is markedly more atherogenic than LDL: an apolipoprotein B-based genetic analysis. J Am Coll Cardiol. 2024;83(3):385-395. 16. Kronenberg F, Mora S, Stroes ESG, et al. Lipoprotein(a) in atherosclerotic cardiovascular disease and aortic stenosis: a European Atherosclerosis Society consensus statement. Eur Heart J. 2022;43(39):3925-3946. 17. Willeit P, Ridker P, Nestel P, et al. Baseline and on-statin treatment lipoprotein(a) levels for prediction of cardiovascular events: individual patient-data meta-analysis of statin outcome trials. Lancet. 2018;392(10155):1311-1320. 18. Byrne H, Sinha S, Pradhan H, et al. How common is elevated Lp(a) in premature ASCVD patients? A real-world study using a large US electronic health record database. Poster presented at: European Atherosclerosis Society (EAS) Congress; May 4-7, 2025; Glasgow, UK. 19. Writing Committee, Lloyd-Jones DM, Morris PB, et al. 2022 ACC Expert Consensus Decision Pathway on the Role of Nonstatin Therapies for LDL-Cholesterol Lowering in the Management of Atherosclerotic Cardiovascular Disease Risk: A Report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol. 2022;80:1366-1418. 20. Grundy SM, Stone NJ, Bailey AL, et al. 2018 
AHA/ACC/AACVPR/AAPA/ABC/ACPM
/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol. Circulation. 2019;139(25):e1082-e1143. 21. Arnett DK, Blumenthal RS, Albert MA, et al. 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease. Circulation. 2019;140(11):e596-e646.