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Related Concept Videos

Blood Studies for Cardiovascular System III: Serum Lipid Profile01:25

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Understanding serum lipids is crucial for maintaining cardiovascular health and preventing heart disease and stroke.
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Related Experiment Video

Updated: Jul 6, 2025

Cell-free Biochemical Fluorometric Enzymatic Assay for High-throughput Measurement of Lipid Peroxidation in High Density Lipoprotein
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Lipoprotein a - Lp(a).

Tapan Ghose1

  • 1Director and Head of Cardiology, Fortis Flt Lt Rajan Dhall Hospital New Delhi, 11-0070, India.

Indian Heart Journal
|December 31, 2023
PubMed
Summary

Elevated lipoprotein(a) [Lp(a)] is a key genetic risk factor for atherosclerotic cardiovascular disease (ASCVD). Measuring Lp(a) is recommended, especially with a family history of heart disease, to guide risk management.

Area of Science:

  • Cardiology
  • Genetics
  • Preventive Medicine

Background:

  • Lipoprotein(a) [Lp(a)] is an independent, genetically determined risk factor for atherosclerotic cardiovascular disease (ASCVD).
  • Approximately 20% of the global population and 25% of Indians have elevated Lp(a) levels (>50 mg/dL or >125 nmol/L).
  • Elevated Lp(a) is linked to increased risks of myocardial infarction, stroke, heart failure, and mortality through pro-inflammatory and pro-atherogenic mechanisms.

Purpose of the Study:

  • To highlight the significance of lipoprotein(a) [Lp(a)] as a causal risk factor for atherosclerotic cardiovascular disease (ASCVD).
  • To emphasize the prevalence of elevated Lp(a) and its association with cardiovascular events and mortality.
  • To discuss current recommendations for Lp(a) measurement, cascade testing, and emerging therapeutic strategies.
Keywords:
Lipoprotein(a)Lp(a)Non-conventional risk factor of CAD

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Main Methods:

  • Review of epidemiological, genome-wide association, and mendelian randomization studies.
  • Analysis of Lp(a) levels in various clinical settings and populations, including a recent Indian study on coronary artery disease (CAD) patients.
  • Evaluation of emerging Lp(a)-lowering therapies such as PCSK9 inhibitors, Inclisiran, and Pelacarsen.

Main Results:

  • Epidemiological and genetic studies confirm Lp(a) as a causal ASCVD risk factor.
  • Elevated Lp(a) levels are associated with increased incidence of myocardial infarction, stroke, and mortality.
  • A recent Indian study found elevated Lp(a) correlated with severe angiographic disease in CAD patients, particularly in young patients with familial hypercholesterolemia (FH).

Conclusions:

  • Lipoprotein(a) [Lp(a)] is a critical, heritable risk factor for atherosclerotic cardiovascular disease (ASCVD) that warrants lifelong monitoring.
  • Measurement of Lp(a) is recommended at least once in a lifetime, with cascade testing for individuals with a family history of high Lp(a) or premature ASCVD.
  • While comprehensive risk factor management is crucial, novel Lp(a)-lowering therapies like Pelacarsen show significant potential for reducing cardiovascular risk.