Statins
Starting statins raises Lp(a) only in patients with the low molecular weight apo(a) phenotype, a study of 81 patients (Atherosclerosis 2019)
Original title: Statin treatment increases lipoprotein(a) levels in subjects with low molecular weight apolipoprotein(a) phenotype
Researchers evaluated the effect of starting statin treatment on Lp(a) levels in 39 patients initiating therapy and 42 patients already on stable statin treatment, most with familial hypercholesterolaemia, examining interactions with apolipoprotein(a) [apo(a)] phenotype and LPA gene variants. Overall, Lp(a) did not increase significantly in the initiation group (median 20.5 to 23.3 mg/dL, P=0.09) or the control group (30.9 to 31.7 mg/dL, P=0.61). However, in patients with the low molecular weight (LMW) apo(a) phenotype, Lp(a) rose significantly from 66.4 to 97.4 mg/dL (P=0.026) in the initiation group, an effect not seen in the control group or in patients with the high molecular weight (HMW) phenotype. Interactions with common LPA SNPs and change in LDL cholesterol were not significant. The findings show statins selectively raise Lp(a) in patients with the LMW apo(a) phenotype.
Original abstract
Background And Aims: We aimed to evaluate the effect of statin treatment initiation on lipoprotein(a) [Lp(a)] levels in patients with dyslipidemia, and the interactions with the apolipoprotein(a) [apo(a)] phenotype, LPA single nucleotide polymorphisms (SNPs) and change in LDL cholesterol.
Methods: The study population consisted of patients with dyslipidemia, predominantly familial hypercholesterolemia, who first initiated statin treatment (initiation group; n = 39) or were already on stable statin treatment for at least 4 months (control group; n = 42). Plasma Lp(a) levels were determined with a particle-enhanced immunoturbidimetric assay before and at least 2 months after start of statin treatment in individuals of the initiation group, and at two time points with an interval of at least 2 months in the control group. High and low molecular weight (HMW and LMW, respectively) apo(a) phenotype was determined by immunoblotting, and the common LPA SNPs rs10455872, rs3798220 and rs41272110 by Taqman assay.
Results: Plasma Lp(a) levels did not increase significantly in the initiation group (median 20.5 (IQR 10.9-80.7) to 23.3 (10.8-71.8) mg/dL; p = 0.09) nor in the control group (30.9 (IQR 9.2-147.0) to 31.7 (IQR 10.9-164.0) mg/dL; p = 0.61). In patients with the LMW apo(a) phenotype, Lp(a) levels increased significantly from 66.4 (IQR 23.5-148.3) to 97.4 (IQR 24.9-160.4) mg/dL (p = 0.026) in the initiation group, but not in the control group and not in patients characterized by the HMW apo(a) phenotype. Interactions with common LPA SNPs and change in LDL cholesterol were not significant.
Conclusions: Statins affect Lp(a) levels differently in patients with dyslipidemia depending on the apo(a) phenotype. Statins increase Lp(a) levels exclusively in patients with the LMW apo(a) phenotype.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.