Statins
LDL-C targets are met in only a fifth of very-high-Lp(a) patients despite statins, Spanish lipid-unit study of 265 (Clin Investig Arterioscler 2026)
Original title: Prevalence of elevated lipoprotein(a) levels and associated atherosclerotic cardiovascular diseases in subjects with metabolic disorders: A real-world study in a lipid unit
Retrospective lipid-unit study of 1755 subjects, of whom 265 had Lp(a) 240 nmol/L or more, divided into high (240-429 nmol/L, n=216) and very high (430 nmol/L or more, n=49) Lp(a) groups, evaluating ASCVD prevalence and LDL-C target attainment. ASCVD prevalence was 58% in the very-high and 48% in the high Lp(a) group (p=0.23); age and statin intensity were greater in the very-high group. LDL-C target attainment was low in both groups: only 20.0% (very high) and 25.4% (high) of very-high-cardiovascular-risk patients reached below 55 mg/dL, and 18.2% and 17.2% of high-risk patients reached below 70 mg/dL. The authors conclude patients with elevated Lp(a) show high ASCVD prevalence and poor LDL-C goal attainment despite high-intensity statin therapy, supporting the need for Lp(a) screening and additional lipid-lowering strategies in high-risk patients.
Original abstract
Background And Aims: Lipoprotein(a) (Lp(a)) is a proatherogenic particle that is considered an important cardiovascular risk modifier due to its association with atherosclerotic cardiovascular disease (ASCVD) as well as calcific aortic valve stenosis (CAVS). Data on the clinical burden associated with elevated lipoprotein(a) levels in patients at high and very high cardiovascular risk remain limited. We evaluated the prevalence of ASCVD and LDL-C target achievement in subjects with high and very high elevated Lp(a) levels referred to a lipid unit.
Methods And Results: In this retrospective study, 1755 subjects were evaluated; 265 with Lp(a) ≥240nmol/L were included. The population was divided into two groups: high Lp(a) (240-429nmol/L, n=216) and very high Lp(a) (≥430nmol/L, n=49). ASCVD prevalence was 58% in the very high group and 48% in the high group (p=0.23). Age and statin intensity were higher in the very high Lp(a) group. LDL-C target achievement was low in both groups: 20.0% and 25.4% of very high-risk patients reached <55mg/dL as well as 18.2% and 17.2% of high-risk patients reached <70mg/dL in very high and high Lp(a) groups, respectively.
Conclusions: Subjects with elevated Lp(a) levels showed a high prevalence of ASCVD and low LDL-C target attainment despite high-intensity statin therapy. These findings support the need for Lp(a) screening and additional lipid-lowering strategies in high-risk patients.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 17 August 2026. Methods.