Aortic stenosis
A cardiac surgeon's perspective argues Lp(a) testing should refine risk assessment after aortic valve replacement and heart transplantation (Int J Cardiol Cardiovasc Risk Prev 2024)
Original title: Lipoprotein (a) and lipid-lowering treatment from the perspective of a cardiac surgeon. An impact on the prognosis in patients with aortic valve replacement and after heart transplantation
This article summarises the role of Lp(a) and lipid-lowering treatment specifically for patients who have undergone aortic valve replacement (AVR) or heart transplantation (HTx), conditions in which elevated Lp(a) significantly affects prognosis. With no targeted Lp(a) therapy yet approved, the authors note pelacarsen, olpasiran, zerlasiran, lepodisiran and muvalaplin are all in clinical trials and have demonstrated effective Lp(a) reduction. The authors argue that measuring Lp(a) in AVR and HTx patients would allow more accurate cardiovascular risk stratification in these specific surgical populations, and that once effective Lp(a)-lowering therapy becomes available, it could help optimise that risk, offering a cardiac-surgery-specific lens on Lp(a) management that is often overlooked in general cardiology reviews.
Original abstract
Lipoprotein(a) is a recognized risk factor for ASCVD. There is still no targeted therapy for Lp(a), however, drugs such as pelacarsen, olpasiran, zerlasiran, lepodisiran and muvalaplin are in clinical trials and have been shown to be effective in significantly reducing Lp(a) levels. Moreover, elevated Lp(a) levels significantly affect the prognosis of patients after aortic valve replacement (AVR) and heart transplantation (HTx). Therefore, the assessment of Lp(a) concentration in these patients will allow for a more accurate stratification of their cardiovascular risk, and the possibility of lowering Lp(a) will allow for the optimization of this risk. In this article, we summarized the most important information regarding the role of Lp(a) and lipid-lowering treatment in patients after AVR and HTx.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.