Language
English
Publication Date
6-1-2024
Journal
American Journal of Preventive Cardiology
DOI
10.1016/j.ajpc.2024.100651
PMID
38646021
PMCID
PMC11031736
PubMedCentral® Posted Date
4-3-2024
PubMedCentral® Full Text Version
Post-print
Abstract
High levels of lipoprotein(a) [Lp(a)] are causal for atherosclerotic cardiovascular disease (ASCVD). Lp(a) is the most prevalent inherited dyslipidemia and strongest genetic ASCVD risk factor. This risk persists in the presence of at target, guideline-recommended, LDL-C levels and adherence to lifestyle modifications. Epidemiological and genetic evidence supporting its causal role in ASCVD and calcific aortic stenosis continues to accumulate, although various facets regarding Lp(a) biology (genetics, pathophysiology, and expression across race/ethnic groups) are not yet fully understood. The evolving nature of clinical guidelines and consensus statements recommending universal measurements of Lp(a) and the scientific data supporting its role in multiple disease states reinforce the clinical merit to start population screening for Lp(a) now. There is a current gap in the implementation of recommendations for primary and secondary cardiovascular disease (CVD) prevention in those with high Lp(a), in part due to a lack of protocols for management strategies. Importantly, targeted apolipoprotein(a) [apo(a)]-lowering therapies that reduce Lp(a) levels in patients with high Lp(a) are in phase 3 clinical development. This review focuses on the identification and clinical management of patients with high Lp(a). Specifically, we highlight the clinical value of measuring Lp(a) and its use in determining Lp(a)-associated CVD risk by providing actionable guidance, based on scientific knowledge, that can be utilized now to mitigate risk caused by high Lp(a).
Keywords
Lipoprotein(a) [Lp(a)], Cardiovascular Disease (CVD), Lp(a) testing, Risk mitigation
Published Open-Access
yes
Recommended Citation
Reyes-Soffer, Gissette; Yeang, Calvin; Michos, Erin D; et al., "High Lipoprotein(a): Actionable Strategies for Risk Assessment and Mitigation" (2024). Faculty, Staff and Students Publications. 6658.
https://digitalcommons.library.tmc.edu/baylor_docs/6658