What condition is associated with an increased risk due to elevated Lipoprotein(a) (Lp(a))?

From the Guidelines

Elevated Lipoprotein(a) (Lp(a)) is associated with an increased risk of Cardiovascular Disease (CVD) and Aortic Stenosis.

Conditions Associated with Elevated Lp(a)

• Cardiovascular Disease (CVD): including myocardial infarction, stroke, peripheral arterial disease, and heart failure 1
• Aortic Stenosis: calcific aortic valve disease (CAVD) 1
• Coronary Artery Disease (CAD): elevated Lp(a) levels contribute to the incidence of CAD 1

Key Findings

• Lp(a) levels in the atherothrombotic range are generally accepted as >30–50 mg/dL or >75–125 nmol/L 1
• Elevated Lp(a) affects 20–30% of the global population, with possibly higher incidence in patients with established CVD and CAVD 1
• Convincing evidence has emerged from pathophysiological, epidemiologic, and genetic studies on the causality of Lp(a) in contributing to CVD and CAVD 1

Measurement and Treatment

• Lp(a) measurement is important in assessing cardiovascular risk, particularly in patients with elevated levels 1
• Niacin decreases Lp(a) levels, but its effect on stroke is not significant 1
• Emerging therapies, such as antisense therapy, may provide new options for lowering Lp(a) levels 1

From the Research

Condition Associated with Elevated Lipoprotein(a) (Lp(a))

Elevated Lipoprotein(a) (Lp(a)) is associated with an increased risk of:

• Atherosclerotic cardiovascular disease (ASCVD) 2, 3, 4, 5, 6
• Calcific aortic stenosis/calcific aortic valve disease (AS/CAVD) 4
• Major adverse cardiovascular events (MACE) across different high-sensitivity C-reactive protein (hs-CRP) levels 5
• Myocardial infarction and stroke 6
• Valvular aortic stenosis 6

Key Findings

• High levels of Lp(a) are an independent and causal risk factor for ASCVD 2, 3, 4
• Lp(a) remains a risk factor for cardiovascular disease development even in the setting of effective reduction of plasma low-density lipoprotein cholesterol and apoB100 2
• Elevated Lp(a) is associated with an increased risk of MACE independent of hs-CRP levels in both primary and secondary prevention populations 5