Case series: two young patients presented with spontaneous coronary dissection and thrombosis alongside high Lp(a), not atherosclerosis (J Clin Lipidol 2025)

This case series describes two young patients who presented with acute coronary syndrome and, on investigation, were found to have spontaneous coronary artery dissection complicated by thrombosis, without significant underlying atherosclerotic plaque burden, but with markedly elevated Lp(a). The authors note that young ACS patients often lack traditional atherosclerotic risk factors, complicating both diagnostic imaging interpretation and identification of an underlying cause, and propose that high Lp(a), through its prothrombotic properties, may contribute to spontaneous coronary dissection and associated thrombosis in this population independent of atherosclerosis, warranting further investigation.