Testing
Lp(a) testing is already actionable in primary prevention, Parcha and Bittner argue, proposing a pragmatic clinical framework (Am Heart J Plus 2025)
Original title: Lipoprotein (a) in primary cardiovascular disease prevention is actionable today
This review by Parcha and Bittner argues that despite growing evidence of Lp(a)'s causal role in atherosclerotic cardiovascular disease and calcific aortic valve disease, its actionability in primary prevention remains underrecognised in everyday practice. Using clinical vignettes and current data, the authors summarise the scientific foundation for early Lp(a) measurement, its pathogenic mechanisms, and the evolving therapeutic landscape, then propose a pragmatic clinical framework for integrating Lp(a) into preventive cardiology today. They argue that identifying elevated Lp(a) can meaningfully guide risk reclassification, intensify management of other modifiable risk factors, and inform patient-centred preventive strategies, making the case that Lp(a) testing is actionable now rather than a future prospect awaiting dedicated therapies.
Original abstract
Lipoprotein(a) [Lp(a)] has emerged as an important, genetically determined, and independent risk factor for atherosclerotic cardiovascular disease (ASCVD) and calcific aortic valve disease. Despite growing evidence of its causal role in cardiovascular morbidity and mortality, its actionability in primary prevention remains underrecognized. This review highlights the contemporary scientific foundation supporting early Lp(a) measurement, elucidates its pathogenic mechanisms, evaluates the evolving therapeutic landscape, and proposes a pragmatic clinical framework for integrating Lp(a) into preventive cardiology today. Through clinical vignettes and current data, we argue that identifying elevated Lp(a) can meaningfully guide risk reclassification, intensify modifiable risk management, and inform patient-centered preventive strategies thereby making Lp(a) testing actionable in contemporary primary prevention.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 17 August 2026. Methods.