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Review finds bempedoic acid lowers LDL-C and hs-CRP well but has minimal effect on Lp(a) (Curr Opin Cardiol 2024)

Original title: Effects of bempedoic acid on markers of inflammation and Lp(a)

Curr Opin Cardiol · · 5

Reddy S, Deoker A

This review examines bempedoic acid, a newer lipid-lowering agent that inhibits ATP-citrate lyase in the cholesterol biosynthesis pathway, specifically for its effects on inflammation markers and Lp(a). Randomised clinical trials show bempedoic acid significantly reduces LDL cholesterol and high-sensitivity C-reactive protein, and meta-analyses confirm reductions in non-HDL cholesterol, total cholesterol, and apolipoprotein B. However, the drug has minimal effect on Lp(a) levels. The authors position bempedoic acid as a useful option for patients with elevated or residual cardiovascular risk despite LDL-C goal attainment, and for statin-intolerant patients, given its LDL-C and inflammatory benefits, while noting it does not address the separate residual risk carried by elevated Lp(a).

Read the paper (DOI)PubMed

Original abstract

Purpose Of Review: To study the effect of bempedoic acid on markers of inflammation and lipoprotein (a) to help determine if the drug would be useful to treat patients with elevated cardiovascular risks and residual cardiovascular risk despite optimal low-density lipoprotein cholesterol (LDL-C) levels.

Recent Findings: Bempedoic acid is found to cause significant reduction in LDL-C and high-sensitivity C-reactive protein (hs-CRP) in various randomized clinical trials. Multiple meta-analyses have also found that bempedoic acid therapy leads to reduction in non-high-density lipoprotein cholesterol (non-HDL-C), total cholesterol (TC) and apolipoprotein B (ApoB) levels. However, it has minimal effect on lipoprotein (a) (Lp(a)) level.

Summary: Bempedoic acid is a new lipid-lowering agent that inhibits enzyme ATP-citrate lyase in the cholesterol biosynthesis pathway. Major risk of cardiovascular events and its associated morbidity and mortality are proportional to LDL-C and inflammatory markers levels. It was found that bempedoic acid significantly lowers LDL-C, hs-CRP and other inflammatory markers levels. This drug could potentially be used in patients with elevated cardiovascular risk, in patients with residual cardiovascular risk despite attaining LDL-C goal and in statin intolerant patients.

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Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.