Lp(a) as a shared driver of atherosclerosis, aortic stenosis and abdominal aortic aneurysm, with lowering therapies now in outcomes trials (Annu Rev Med 2026)

This review by Koschinsky, Kalra and Boffa synthesises the clinical and mechanistic evidence that elevated lipoprotein(a) is an independent, causal risk factor across three distinct vascular beds: atherosclerotic cardiovascular disease, calcific aortic stenosis, and abdominal aortic aneurysm. It links this shared risk to overlapping pathophysiology, including oxidised phospholipid delivery and pro-inflammatory signalling, and surveys the highly potent Lp(a)-lowering agents now being tested in cardiovascular outcomes trials for their ability to prevent major adverse coronary events and slow aortic stenosis progression. As a comprehensive synthesis from established Lp(a) researchers, it is a useful reference as the outcomes-trial era approaches, though it reports no new primary data.