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Lipoprotein(a) Elevation: A New Diagnostic Code with Relevance to Service Members and Veterans
Renata J M Engler1, Emily Brede1, Todd Villines1
1is a Professor of Medicine and Pediatrics and is an Adjunct Assistant Professor of Medicine at the Uniformed Services University of the Health Sciences in Bethesda, Maryland. is a Professor of Medicine in the Cardiology Division at the University of Virginia Health System in Charlottesville, Virginia. is a Protocol Developer; Renata Engler is a Consultant of Cardiovascular Immunology, Diagnostic Laboratory Immunology, Allergy-Immunizations, Integrative Medicine and Research; and Marina Vernalis is Medical Director, Integrative Cardiac Health Project, Cardiology; all at the Henry M. Jackson Foundation, in Bethesda.
Insights
Lipoprotein(a) [Lp(a)] elevation is a significant risk factor for cardiovascular disease. Consider Lp(a) testing in patients with premature atherosclerosis or family history, especially with few traditional risk factors.
Area of Science:
- Cardiology
- Clinical Diagnostics
- Biochemistry
Background:
- Lipoprotein(a) [Lp(a)] is an emerging independent risk factor for atherosclerotic cardiovascular disease (ASCVD).
- Elevated Lp(a) levels contribute significantly to cardiovascular risk, particularly in specific patient populations.
- Understanding Lp(a)'s role is crucial for comprehensive cardiovascular risk assessment.
Purpose of the Study:
- To highlight the clinical significance of elevated Lipoprotein(a) [Lp(a)] as a major contributor to cardiovascular disease risk.
- To emphasize the importance of considering Lp(a) testing in specific patient groups.
- To guide clinicians in identifying individuals who may benefit from Lp(a) assessment.
Main Methods:
- Review of current clinical guidelines and research on Lp(a) and cardiovascular disease.
- Analysis of patient profiles with advanced premature atherosclerosis and family history of premature cardiovascular disease.
- Evaluation of the association between Lp(a) levels and cardiovascular risk in patients with limited traditional risk factors.
Main Results:
- Lipoprotein(a) [Lp(a)] elevation is a newly recognized clinical diagnosis and a significant driver of cardiovascular risk.
- Patients with advanced premature atherosclerosis or a family history of premature cardiovascular disease are key candidates for Lp(a) evaluation.
- The clinical utility of Lp(a) testing is particularly pronounced in individuals with a low burden of traditional cardiovascular risk factors.
Conclusions:
- Elevated Lipoprotein(a) [Lp(a)] should be considered a critical factor in cardiovascular risk stratification.
- Routine consideration of Lp(a) testing is warranted in patients presenting with premature atherosclerosis or a relevant family history.
- Identifying and managing elevated Lp(a) can improve cardiovascular disease prevention strategies, especially in at-risk individuals with fewer conventional risk factors.
Abstract:
Newly recognized as a clinical diagnosis, Lp(a) elevation is a major contributor to cardiovascular disease risk should be considered for patients with advanced premature atherosclerosis on imaging or a family history of premature cardiovascular disease, particularly when there are few traditional risk factors.
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