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Consideration and Application of Lipoprotein(a) in the Risk Assessment of Atherosclerotic Cardiovascular Disease Risk

Tiffany Yuen1, G B John Mancini2, Robert A Hegele3

  • 1Faculty of Medicine & Dentistry, University of Alberta, Mazankowski Alberta Heart Institute, Edmonton, Alberta, Canada.

CJC Open
|April 1, 2024
PubMed

Insights

High lipoprotein(a) (Lp[a]) levels are a significant risk factor for cardiovascular disease. Measuring Lp(a) once is recommended for assessing atherosclerotic cardiovascular disease (ASCVD) risk.

Area of Science:

  • Cardiology
  • Biochemistry
  • Genetics

Background:

  • Lipoprotein(a) (Lp[a]) is an LDL-like particle containing apoB and apo(a).
  • Elevated Lp(a) is an independent, causal risk factor for atherosclerotic cardiovascular disease (ASCVD) and aortic valve disease.
  • Lp(a) promotes atherogenesis, inflammation, and thrombosis, with risk linearly associated with Lp(a) levels.

Purpose of the Study:

  • To review the utility and application of Lp(a) measurement in ASCVD risk assessment.
  • To provide an update on Lp(a) in the context of adult cardiovascular risk management.
  • To align with the 2021 Canadian Cardiovascular Society Dyslipidemia Guidelines recommendation for Lp(a) screening.

Main Methods:

  • Literature review of studies on Lp(a) and cardiovascular risk.
  • Analysis of the role of Lp(a) in atherogenesis, inflammation, and thrombosis.
  • Examination of current guidelines regarding Lp(a) testing.

Main Results:

  • Reliable assays for Lp(a) are available, enabling clinical assessment.
  • Lp(a) levels show a linear association with ASCVD risk.
  • The 2021 Canadian Cardiovascular Society guidelines recommend a one-time Lp(a) measurement for lipid screening.

Conclusions:

  • Lp(a) is a crucial, actionable risk marker for ASCVD.
  • Routine Lp(a) measurement aids in identifying individuals at elevated cardiovascular risk.
  • Understanding Lp(a) is vital for comprehensive ASCVD risk assessment and management.

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