Guidelines and consensus 127 items
The EAS 2010 and 2022 statements, ESC/EAS 2019 and the 2025 focused update, the 2018 and 2026 US guidelines, NLA 2019 and 2024, CCS 2021, HEART UK 2019 and the Brussels declaration.
Trials, agents, guidance
- Guideline 2026 ACC/AHA multisociety guideline on the management of dyslipidemia
- Guideline 2025 focused update of the ESC/EAS dyslipidaemia guidelines
- Guideline Brussels International Declaration on Lp(a) testing and management (2025)
- Guideline NLA focused update on the use of Lp(a) in clinical practice (2024)
- Guideline EAS consensus statement on Lp(a) in ASCVD and aortic stenosis (2022)
- Guideline AHA scientific statement: Lp(a) as a genetically determined, causal and prevalent risk factor (2022)
- Guideline 2021 Canadian Cardiovascular Society dyslipidemia guidelines
- Guideline HEART UK consensus statement on Lp(a): a call to action (2019)
- Guideline 2019 ESC/EAS guidelines for the management of dyslipidaemias
- Guideline EAS consensus panel: Lp(a) as a cardiovascular risk factor, current status (2010)
Studies
- The 2022 EAS consensus statement on Lp(a) in ASCVD and aortic stenosis (Kronenberg, Mora, Stroes et al., EHJ 2022)
- Lp(a) as a cardiovascular risk factor: the first EAS consensus panel (Nordestgaard et al., EHJ 2010)
- 2026 ACC/AHA multisociety guideline on the management of dyslipidemia (Blumenthal, Morris et al., Circulation 2026)
- 2025 focused update of the 2019 ESC/EAS dyslipidaemia guidelines (Mach, Koskinas, Roeters van Lennep et al., EHJ 2025)
- 2019 ESC/EAS guidelines for the management of dyslipidaemias (Mach et al., EHJ 2020)
- Thirty-year cardiovascular risk in healthy women by Lp(a) threshold: the Women's Health Study (Nordestgaard AT et al., JAMA Cardiol 2026)
- What existing lipid-lowering drugs do to Lp(a): meta-analysis of 147 RCTs (Xie et al., Atherosclerosis 2025)
- NLA focused update 2024: measure Lp(a) at least once in every adult, with three risk bands (Koschinsky et al., J Clin Lipidol 2024)
- AHA scientific statement: Lp(a) is a genetically determined, causal and prevalent risk factor for ASCVD (Reyes-Soffer et al., ATVB 2022)
- NLA scientific statement: use of Lp(a) in clinical practice, a biomarker whose time has come (Wilson et al., J Clin Lipidol 2019)
- The Brussels International Declaration on Lp(a) testing and management (Kronenberg et al., Atherosclerosis 2025)
- Thirty frequent questions on the 2022 EAS Lp(a) consensus, answered (Kronenberg, Mora, Stroes et al., Atherosclerosis 2023)
- Ancestry, Lp(a) and cardiovascular risk thresholds (Tsimikas and Marcovina, JACC 2022)
- 2021 Canadian Cardiovascular Society dyslipidaemia guidelines: Lp(a) once in a lifetime (Pearson et al., Can J Cardiol 2021)
- HEART UK consensus statement on Lp(a): a call to action (Cegla et al., Atherosclerosis 2019)
- 2018 AHA/ACC guideline on the management of blood cholesterol: Lp(a) as a risk-enhancing factor (Grundy et al., Circulation 2019)
- NHLBI working group recommendations to reduce Lp(a)-mediated risk of CVD and aortic stenosis (Tsimikas et al., JACC 2018)
- Efficacy and Safety of Oral PCSK9 Inhibitor Enlicitide in Adults With Heterozygous Familial Hypercholesterolemia: A Randomized Clinical Trial
- The Polish Cardiac Society and Polish Lipid Association publish the country first expert recommendations on diagnosing and managing elevated lipoprotein(a) (Arch Med Sci 2024)
- The Spanish Society of Arteriosclerosis issues a consensus statement on lipoprotein(a), testing limitations, cardiovascular risk and treatment recommendations (Clin Investig Arterioscler 2024)
- The Italian Society for the Study of Atherosclerosis publishes a national consensus on lipoprotein(a) testing and management (Nutr Metab Cardiovasc Dis 2023)
- The Australian Atherosclerosis Society issues a position statement recommending selective, not universal, Lp(a) screening for intermediate-to-high-risk patients (Heart Lung Circ 2023)
- The Beijing Heart Society issues an expert scientific statement on Lp(a) and cardiovascular disease specific to the Chinese population (JACC Asia 2022)
- Seven international stakeholder organisations convene a global think tank to answer clinicians top questions on managing Lp(a) (Prog Cardiovasc Dis 2022)
- The French Society of Atherosclerosis issues a consensus statement recommending Lp(a) testing be covered by national health insurance (Arch Cardiovasc Dis 2021)
- A Global Think Tank of major cardiovascular societies reaches unanimous consensus on standardising Lp(a) measurement, but not on universal screening (J Clin Lipidol 2021)
- New antisense and RNA interference drugs may lower Lp(a) by up to 90%, a JCL Roundtable expert discussion on the emerging risk factor (J Clin Lipidol 2018)
- 2026 ACC/AHA guideline recommends universal one-time Lp(a) testing, review for endocrinologists on managing elevated levels (J Clin Endocrinol Metab 2026)
- Lp(a) above 46.8 nmol/L, below current guideline thresholds, still raises MACE risk 20% in statin-treated patients, UK Biobank cohort of 17,376 (Eur J Prev Cardiol 2026)
- Taiwan Society of Lipid and Atherosclerosis issues 2026 Lp(a) consensus on diagnosis and risk management (J Formos Med Assoc 2026)
- Lp(a) testing is linked to more aggressive lipid treatment and better LDL-C goal attainment, Veterans Affairs cohort of 6.9 million (J Am Heart Assoc 2026)
- Canadian Cardiovascular Society practical framework for Lp(a) screening, risk assessment and management (Can J Cardiol 2026)
- Korean Lp(a) task force proposes a 3-tier classification (30/50 mg/dL) tailored to Korean cohorts, position paper (J Lipid Atheroscler 2026)
- Lp(a) testing for primary prevention is cost-saving across every high-income country modelled, multinational microsimulation finds (Atherosclerosis 2025)
- A Lancet review by Nordestgaard and Langsted finds one in five people carry high-risk Lp(a), as five lowering drugs achieve 65-98% reductions in trials (Lancet 2024)
- Tsimikas marks Lp(a)'s 61st birthday with an ATVB Centennial essay on six decades of discovery and three ongoing outcome trials (Arterioscler Thromb Vasc Biol 2024)
- Lipoprotein(a) and residual cardiovascular risks in Japanese patients with coronary artery disease who achieve guideline-recommended LDL-C goals
- Comparative associations of LDL-C, Lp(a), hsCRP, and IL-6 with cardiovascular risk: Insights from the UK Biobank and MESA
- The Lp(a) implementation gap: screening stays below 1% despite affecting 20% of the world, review (Rev Cardiovasc Med 2026)
- A practical roadmap for managing elevated Lp(a) today, from apheresis's 60-75% cut to RNA agents' 80-95%, while outcomes trials are pending (Semin Thromb Hemost 2025)
- Fifteen years of Lp(a) guidelines have moved toward universal screening, but important evidence gaps remain, Boffa, Koschinsky and Hegele find (Curr Opin Lipidol 2025)
- Only half of physicians with access to Lp(a) testing use it routinely, and a third can't define an elevated result, INTERASPIRE survey across 7 countries finds (Eur J Prev Cardiol 2025)
- Global Lp(a) testing rose from 0.009% to just 0.032% of adults between 2015 and 2023, TriNetX analysis of 141 million patients finds (Am Heart J 2025)
- Lp(a) meets most established criteria for a population screening test, on health, societal and cost grounds, review by Koschinsky and Thanassoulis's group argues (Eur J Prev Cardiol 2025)
- Kamstrup, Nordestgaard and colleagues propose minimum data standards to harmonise future Lp(a) observational research (Eur J Prev Cardiol 2024)
- Reyes-Soffer, Yeang, Michos and Ballantyne argue Lp(a) population screening should start now, ahead of phase 3 apo(a)-lowering trial results (Am J Prev Cardiol 2024)
- Three phase 3 Lp(a)-lowering outcomes trials will start reporting from 2025, a National Lipid Association Expert Panel maps what remains unknown about lipoprotein(a) (J Clin Lipidol 2024)
- 75.5% of surveyed European lipid clinicians routinely measure Lp(a), but reimbursement and treatment gaps remain barriers, an EAS Lipid Clinics Network survey (Atherosclerosis 2023)
- Nissen and Laffin call Lp(a) an overlooked risk factor affecting 20-30% of the world's population, as pharmacotherapies advance (Trends Cardiovasc Med 2024)
- Lp(a) above the 90th decile raises coronary artery disease risk by 62% in routinely tested patients, a 14-year Swedish follow-up of 23,398 people (Eur J Prev Cardiol 2022)
- Lipoprotein(a) and Benefit of PCSK9 Inhibition in Patients With Nominally Controlled LDL Cholesterol
- Gulf countries expert consensus endorses routine Lp(a) testing in cardiovascular risk assessment (Atheroscler Plus 2026)
- PCSK9 inhibitors lower Lp(a) by 20-30%, with tafolecimab strongest in East Asians, review (J Cardiovasc Pharmacol 2026)
- The impact of lipid apheresis on changes of lipoprotein(a): a systematic review and meta-analysis
- Routine Lp(a) testing changed management in most UK lipid clinic patients above 50 mg/dL, even without an Lp(a)-specific drug (Curr Med Res Opin 2026)
- Only 36.7% of surveyed Latin American physicians request Lp(a) testing, citing unavailability and cost as the main barriers (BMC Cardiovasc Disord 2025)
- 81% of US clinicians see Lp(a) as a major risk driver, but only 41% back universal testing, national survey of 2,002 (Am J Prev Cardiol 2026)
- A clinical practice review of Lp(a) risk stratification and the emerging lowering agents (Eur J Clin Invest 2026)
- What the suboptimal rollout of LDL-C therapy should teach the field before Lp(a)-lowering drugs reach the clinic, Sarraju and Nissen argue (Am J Prev Cardiol 2025)
- Lp(a) has reached a 'tipping point' where universal one-time screening is justified today, Bhatia argues (Am J Prev Cardiol 2025)
- 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)
- Lp(a) affects up to a quarter of the world's population and carries FH-comparable risk, review argues for universal adult screening and selective pediatric testing (Am J Prev Cardiol 2025)
- The Batary survey of 49 Spanish laboratories finds most lack Lp(a) testing protocols despite 46.87% of results exceeding 30 mg/dL (Clin Investig Arterioscler 2025)
- Annual review names 2024 "the year of lipoprotein(a)" as three RNA-based Lp(a)-lowering agents advance through outcome trials (Arch Med Sci 2025)
- Review consolidates the case for Lp(a) as a causal driver of ASCVD and aortic valve stenosis behind three major guideline bodies (Curr Cardiovasc Risk Rep 2025)
- Review argues an elevated Lp(a) is actionable today, through LDL-C control, PCSK9 inhibitors and aspirin, not just future dedicated drugs (Curr Opin Lipidol 2024)
- Only 81% of surveyed UK lipid clinics can measure Lp(a), and reporting units still vary widely, a national survey (J Clin Lipidol 2024)
- Testing every adult once for Lp(a), cascade screening relatives, and PCSK9 inhibition on top of statins in high-risk patients, a clinical review (Prog Cardiovasc Dis 2024)
- Hegele, Mancini and colleagues update how to apply Lp(a) in ASCVD risk assessment under Canada's once-in-a-lifetime testing guideline (CJC Open 2024)
- International guidelines now support a once-in-a-lifetime Lp(a) measurement in every adult, first phase 3 outcome trial results due in 2025 (Curr Opin Cardiol 2024)
- Lipoprotein(a) should be measured once in a lifetime as part of standard non-fasting lipid testing, German national guidance argues (Dtsch Arztebl Int 2023)
- Testing and treating Lp(a) is clinically actionable today via cascade screening and PCSK9 inhibition or apheresis, a review argues (Curr Cardiol Rep 2023)
- A pan-European/North American comparison of Lp(a) guidelines converges on a risk calculator and lifetime screening, by three leading researchers (Curr Opin Lipidol 2022)
- About 20% of people have elevated Lp(a), yet guidelines diverge sharply on how to manage it, and youth recommendations barely exist, a review (Curr Opin Endocrinol Diabetes Obes 2021)
- Antisense apo(a) and apoB inhibitors could cut Lp(a) by up to 80%, a review of Lp(a)-lowering strategies for coronary disease (Drugs 2020)
- Antisense drug IONIS-APO(a)-LRX cuts Lp(a) by 90% in a phase 2 trial, a review of Lp(a) and atherosclerotic disease (Cardiovasc Drugs Ther 2019)
- Elevated Lp(a) above 50 mg/dL affects 1 in 5 people worldwide, a review of modern genomic insights into Lp(a) (Curr Opin Lipidol 2017)
- Apheresis remains the only option for very high Lp(a) since no drug lowers it without affecting other lipids, a review of Lp(a)-lowering treatments (Curr Med Chem 2017)
- Antisense drug IONIS-APO(a)Rx cuts Lp(a) by about 80%, a review of apolipoprotein(a) antisense oligonucleotides (Curr Pharm Des 2017)
- Lp(a)-lowering therapies range from 20% modest to 80% dramatic reductions, a review of emerging options for cardiovascular prevention (Curr Atheroscler Rep 2016)
- Lp(a) fully expresses by age 2, but guidelines only recommend testing children after stroke, a review of Lp(a) in pediatrics (J Clin Lipidol 2015)
- Distribution of Lipoprotein(a) concentrations in children and young people with Familial Hypercholesterolemia (FH) compared to those without FH: A systematic review and narrative synthesis
- Lipoprotein(a) and premature myocardial infarction: Mechanistic insights and implications for PCI-era residual risk
- Lp(a) screening moves toward routine clinical practice, review for advanced practice clinicians (JAAPA 2026)
- It's time to test all adults for Lp(a), commentary on the 2026 ACC/AHA guideline (J Clin Lipidol 2026)
- Prevalence of Lipoprotein(a) Testing in Patients With Atherosclerotic Cardiovascular Disease Within a Large Australian Cardiology Network
- Lp(a) affects 20% of the population, review of biology, guidelines and the emerging therapy pipeline (Eur Heart J Suppl 2026)
- Lipid-modifying efficacy and safety of obicetrapib in high-risk cardiovascular patients: A systematic review and meta-analysis
- Only two of eighteen GPs routinely tested for Lp(a) before LILAC-for-Lp(a) training reshaped their confidence, multi-method study finds (Front Med (Lausanne) 2026)
- SREBP1, gut-derived TMAO, and Lp(a) all feed 'residual risk' left after LDL-C control, precision-medicine review argues for guideline-integrated management (J Vis Exp 2025)
- A 44-year-old woman with low calculated ASCVD risk but severe, calcified coronary disease illustrates why Lp(a) testing shouldn't wait for guideline mandates, case-based review argues (Am Heart J Plus 2025)
- Real-world data on how elevated Lp(a) patients are actually managed remains scarce, review argues for national and international registries (Curr Opin Lipidol 2025)
- Clinically oriented review outlines how to bring Lp(a) testing into routine Polish practice under the 2025 ESC/EAS update (Arch Med Sci 2025)
- Review argues Lp(a) testing and risk-based management should not wait for outcome-trial results (Atheroscler Plus 2024)
- Practical guidance review outlines managing elevated Lp(a) today while four RNA-based agents complete outcome trials (South Med J 2024)
- Review calls out ethnic and racial disparities in Lp(a) inheritance as an underappreciated piece of the residual-risk puzzle (J Natl Med Assoc 2024)
- A practical clinical guide to Lp(a), genetics, real-world risk-factor interactions, and emerging metabolic targets for lowering it (Prog Cardiovasc Dis 2023)
- About 5% of the population has highly elevated Lp(a), a Norwegian review of assessment and treatment in clinical practice (Tidsskr Nor Laegeforen 2023)
- PCSK9 inhibitors are currently the most effective approved option for lowering Lp(a), but measurement itself lacks a reference standard, a review with practical recommendations (Heart 2022)
- Universal Lp(a) screening meets nearly every criterion except outcome-trial proof that lowering it helps, a review of detection strategies (Curr Opin Endocrinol Diabetes Obes 2023)
- From Kare Berg 1963 discovery to today targeted drugs, a practising clinician guide to Lp(a) (J Clin Med 2022)
- Apheresis remains the most effective Lp(a) treatment while antisense oligonucleotides show promise in phase 2 trials, a review from physiopathology to therapy (Biomedicines 2021)
- Lp(a) is a proven causal cardiovascular risk factor but still lacks a specific therapy or standardised test, a review (J Clin Med 2019)
- Testing for elevated Lp(a) still lacks routine clinical adoption despite causal evidence, a review of screening barriers (Expert Rev Cardiovasc Ther 2019)
- The 2018 cholesterol guideline recognizes elevated Lp(a) as a risk enhancer for statin therapy, a review of Lp(a) as a causal cardiovascular risk factor (Indian Heart J 2019)
- Nephrological guidelines ignore Lp(a) despite its cardiovascular risk in chronic kidney disease, a review calling for better recognition (Clin Res Cardiol Suppl 2017)
- Guidelines recommend Lp(a) testing for risk reclassification in intermediate-risk patients, a review of Lp(a)'s cardiovascular and non-cardiac disease associations (Curr Med Chem 2017)
- Guidelines recommend Lp(a) screening but treatment options remain scarce, a review of Lp(a) as an independent cardiovascular risk marker (Clin Diabetes Endocrinol 2016)
- Numerous drugs developed for other lipid targets also lower Lp(a), but their clinical role remains undetermined, a review of the evolving Lp(a) therapeutic landscape (Curr Atheroscler Rep 2015)
- Lipoprotein(a) and Cardiovascular Disease: From Genetic Risk Factor to Therapeutic Target
Video and podcasts
2025 ESC/EAS focused update: key changes in lipid management (Victoria Delgado, CLIMB 2026)
