Testing
One in five people worldwide has elevated Lp(a), yet testing rates remain poor, review of emerging knowledge and therapies finds (Curr Cardiol Rep 2025)
Original title: Lp(a): Global Public Health Concern: Emerging Knowledge and Therapeutic Approaches
This review by Razavi, Hong and Bhatia surveys new findings and treatment approaches for elevated Lp(a) across the spectrum of atherosclerotic cardiovascular disease (ASCVD). The authors note that roughly one in five people globally has elevated Lp(a) (above 125 nmol/L or 50 mg/dL), yet testing rates remain poor, and they cover emerging knowledge on measurement method comparisons, Lp(a)'s natural variability, its continuous (not threshold-only) association with ASCVD risk, its atherogenicity relative to LDL, its interaction with other risk factors, its link to coronary plaque characteristics, and its association with a broadening range of clinical outcomes. They describe optimal risk-factor control, especially LDL-C lowering, as the current management cornerstone, note shared decision-making around antiplatelet therapy for very-high-Lp(a) individuals, and highlight several Lp(a)-lowering therapies now in ASCVD outcomes trials as management strategies continue to evolve.
Original abstract
Purpose Of Review: Lipoprotein(a) [Lp(a)] is an apolipoprotein B-containing lipoprotein that is a genetic causal risk factor for atherosclerotic cardiovascular disease (ASCVD) and calcific aortic valve disease. This review focuses on new findings and treatment approaches for individuals with elevated Lp(a) across the spectrum of ASCVD.
Recent Findings: One in five individuals globally have elevated Lp(a) (> 125 nmol/L or > 50 mg/dL). Emerging knowledge related to Lp(a) includes demonstration of poor rates of Lp(a) testing, comparison of methods for Lp(a) measurement, natural variability in Lp(a) levels, the continuous association between Lp(a) and ASCVD risk, atherogenicity in comparison with LDL, risk in context of other risk factors, coronary plaque characteristics, and the association of Lp(a) with a broader range of outcomes. Optimal risk factor control, including LDL-cholesterol lowering, is a cornerstone of management. When indicated, shared decision-making to discuss antiplatelet therapy for individuals with very-high Lp(a) may also be helpful. Several Lp(a)-lowering therapies are under investigation in ASCVD outcome trials. While Lp(a) is a well-established risk factor for ASCVD, there are several areas of growing knowledge related to Lp(a), and management strategies of individuals with elevated Lp(a) continue to evolve with targeted therapies currently in late-stage clinical trials.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 17 August 2026. Methods.