Testing
Review argues Lp(a) testing helps solve the ASCVD risk puzzle specifically for statin-poor-responders and diverse populations (Am Heart J Plus 2024)
Original title: Lipoprotein(a): An important piece of the ASCVD risk factor puzzle across diverse populations
This review addresses barriers to routine Lp(a) testing despite its status as an independent, genetic ASCVD risk factor affecting roughly 1.4 billion people worldwide, whose stability over time means most people only need testing once via a simple non-fasting blood draw. The authors outline the clinical benefits of Lp(a) testing, including reclassifying ASCVD risk to drive more intensive risk factor management, identifying patients less likely to respond to statins, and enabling cascade screening in relatives of individuals with a personal or family history of premature ASCVD, while offering practical solutions for common barriers such as limited access and low clinician awareness. The review positions Lp(a) testing as an essential component of cardiovascular risk assessment across diverse patient populations, given its profound and consistent impact on risk regardless of background.
Original abstract
Elevated lipoprotein(a) (Lp[a]) is an independent, genetic risk factor for atherosclerotic cardiovascular disease (ASCVD) that impacts ~1.4 billion people globally. Generally, Lp(a) levels remain stable over time; thus, most individuals need only undergo Lp(a) testing through a non-fasting blood draw once in their lifetime, unless elevated Lp(a) is identified. Despite the convenience of the test for clinicians and patients, routine Lp(a) testing has not been widely adopted. This review provides a guide to the benefits of Lp(a) testing and solutions for overcoming common barriers in practice, including access to testing and lack of awareness. Lp(a) testing provides the opportunity to reclassify ASCVD risk and drive intensive cardiovascular risk factor management in individuals with elevated Lp(a), and to identify patients potentially less likely to respond to statins. Moreover, cascade screening can help to identify elevated Lp(a) in relatives of individuals with a personal or family history of premature ASCVD. Overall, given the profound impact of elevated Lp(a) on cardiovascular risk, Lp(a) testing should be an essential component of risk assessment by primary and specialty care providers.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.