From the Guidelines
Taking a baby aspirin (low-dose aspirin, typically 81 mg daily) is not currently recommended specifically for elevated lipoprotein(a) levels. While research is ongoing regarding treatments for high lipoprotein(a), there is no established evidence that aspirin therapy directly addresses this specific risk factor 1. Management of elevated lipoprotein(a) currently focuses on controlling other cardiovascular risk factors through lifestyle modifications (healthy diet, regular exercise, not smoking) and appropriate treatment of conditions like high LDL cholesterol, hypertension, and diabetes.
Key Considerations
- Aspirin use is generally recommended for adults with diabetes and no previous history of vascular disease who are at increased CVD risk (10-year risk of CVD events over 10%) 1.
- The decision to use aspirin should be based on the overall cardiovascular risk profile, not solely on lipoprotein(a) levels.
- Low-dose aspirin therapy carries bleeding risks and should only be used when recommended by your doctor.
Aspirin Therapy
Aspirin therapy has been shown to reduce the risk of cardiovascular events in certain populations, but the evidence does not support its use specifically for elevated lipoprotein(a) levels 1.
Personalized Risk Reduction Plan
If you have elevated lipoprotein(a), you should work with your healthcare provider to develop a personalized risk reduction plan that takes into account your overall cardiovascular risk profile and addresses other modifiable risk factors. Several promising medications targeting lipoprotein(a) are in clinical trials, but none have yet received regulatory approval specifically for this purpose.
From the Research
Aspirin Therapy for Elevated Lipoprotein(a) Levels
- The use of aspirin for primary prevention of atherosclerotic cardiovascular disease (ASCVD) in individuals with elevated Lipoprotein(a) [Lp(a)] levels has been studied in several research papers 2, 3, 4.
- Elevated Lp(a) levels are associated with an increased risk of ASCVD, and aspirin therapy has been shown to reduce this risk in some studies 2, 3, 4.
- A study published in the Journal of the American Heart Association found that aspirin use was associated with a significant reduction in coronary heart disease (CHD) events among individuals with elevated Lp(a) levels 3.
- Another study published in the American Journal of Preventive Cardiology found that regular aspirin use was associated with a 52% lower risk of ASCVD mortality among individuals with elevated Lp(a) levels 4.
Benefits and Limitations of Aspirin Therapy
- Aspirin therapy has been shown to be beneficial in reducing the risk of ASCVD events in individuals with elevated Lp(a) levels, particularly those with high-risk LPA single nucleotide polymorphisms 2.
- However, the limitations of the available data must be acknowledged, and shared decision-making should be used when discussing aspirin therapy with patients, particularly when balancing potential bleeding risk 2.
- The effectiveness of aspirin therapy in reducing ASCVD risk in individuals with elevated Lp(a) levels may vary depending on factors such as diabetes status, blood lipids, and high-sensitivity C-reactive protein (hs-CRP) levels 5.
Current Recommendations and Future Directions
- There is currently a lack of targeted therapies for treating individuals with elevated Lp(a) levels, and aspirin therapy is being considered as a potential option for primary prevention of ASCVD 2, 6.
- Emerging nucleic acid-based therapies, such as antisense oligonucleotides and small interfering RNAs, are being developed to lower Lp(a) levels and may provide a more targeted approach to reducing ASCVD risk in the future 6.
- Further studies are needed to provide more definitive guidance regarding primary prevention aspirin therapy in individuals with elevated Lp(a) levels and to determine the optimal treatment strategies for this population 2, 3, 4.