Testing
Hegele, Mancini and colleagues update how to apply Lp(a) in ASCVD risk assessment under Canada's once-in-a-lifetime testing guideline (CJC Open 2024)
Original title: Consideration and Application of Lipoprotein(a) in the Risk Assessment of Atherosclerotic Cardiovascular Disease Risk in Adults
This review updates the utility and application of Lp(a) in assessing and treating adults at risk for atherosclerotic cardiovascular disease (ASCVD), consistent with the 2021 Canadian Cardiovascular Society Dyslipidaemia Guidelines' recommendation to measure Lp(a) once in a person's lifetime as part of initial lipid screening. Lp(a), an LDL-like particle with apoB covalently bound to the plasminogen-like apo(a) molecule, is an independent, causal and prevalent ASCVD and aortic valve disease risk factor acting through atherogenic, inflammatory and thrombotic mechanisms, and now benefits from reliable, accessible assays that show a linear relationship between Lp(a) level and ASCVD risk. The authors provide practical guidance for clinicians on incorporating Lp(a) measurement into routine risk assessment and subsequent treatment decisions in line with current Canadian guidance.
Original abstract
Lipoprotein(a) (Lp[a]) is an low-density lipoprotein (LDL)-like particle in which apolipoprotein (apo) B is covalently bound to a plasminogen-like molecule called apo(a). A High level of Lp(a) has been demonstrated to be an independent, causal, and prevalent risk factor for atherosclerotic cardiovascular disease (ASCVD), as well as aortic valve disease, through mechanisms that promote atherogenesis, inflammation, and thrombosis. With reliable and accessible assays, Lp(a) level has been established to be associated linearly with the risk for ASCVD. The 2021 Canadian Cardiovascular Society Dyslipidemia Guidelines recommend measuring an Lp(a) level once in a person's lifetime as part of the initial lipid screening. The aim of this review is to provide an update and overview of the utility and application of Lp(a) level in the assessment and treatment of adults at risk for ASCVD, consistent with this guideline recommendation.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.