Testing
Opinion review argues Lp(a) must move from a neglected biomarker to a routinely measured one now that lowering agents are near approval (Front Cardiovasc Med 2025)
Original title: Lipoprotein(a): the neglected risk factor in cardiovascular health
This review argues that despite being largely genetically determined, stable across life, and now recommended for at least one lifetime measurement by multiple international guidelines, Lp(a) remains rarely measured even in patients with known cardiovascular risk factors. The authors highlight that the therapeutic landscape is changing quickly, with multiple Lp(a)-lowering drugs now in late-stage clinical trials showing considerable promise. They contend the strength and consistency of the causal evidence for Lp(a) in cardiovascular disease is now sufficient to warrant its routine inclusion in risk assessment, and that continuing to omit it will keep underestimating patients' true cardiovascular risk as effective therapies approach the clinic.
Original abstract
Lipoprotein(a) [Lp(a)] is a well recognised contributor in the development of cardiovascular disease. Unlike other lipoproteins, Lp(a) levels are primarily genetically determined, and in most individuals remain largely stable throughout life. Elevated Lp(a) is common in the general population, and various international guidelines now recommend at least one lifetime measurement of Lp(a) and its inclusion into an individual's cardiovascular risk assessment. Despite this, Lp(a) is still rarely measured, even in patients with known cardiovascular risk factors. Critically, the therapeutic landscape for Lp(a)-lowering medications is rapidly evolving with multiple drugs showing considerable promise in late-stage clinical trials. The strength and consistency of the evidence now cement Lp(a) as an essential biomarker of cardiovascular health. Failure to incorporate measurement of Lp(a) into clinical practice will continue to underestimate an individual's risk of CVD. Now is the time for Lp(a) to move from a neglected biomarker to a widely known and measured essential component of cardiovascular risk assessment.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.