Fundamentals of lipoprotein(a) request and quantification in the clinical laboratory

Area of Science:

• Cardiology
• Clinical Biochemistry
• Preventive Medicine

Background:

• Cardiovascular diseases are the leading cause of mortality in Spain.
• Lipoprotein(a) (Lp(a)) is increasingly recognized as an independent risk factor for atherosclerotic cardiovascular events.
• Elevated Lp(a) levels (hyperlipoproteinemia(a)) affect 10-30% of the global population.

Purpose of the Study:

• To review current evidence on Lipoprotein(a) (Lp(a)) testing.
• Identify patient groups who would benefit from Lp(a) quantification.
• Determine optimal Lp(a) measurement methods and target concentrations.

Main Methods:

• Systematic literature review of scientific evidence.
• Analysis of studies associating Lp(a) with cardiovascular risk.
• Evaluation of emerging Lp(a)-lowering therapies.

Main Results:

• Lp(a) is independently associated with increased risk of aortic valve stenosis, heart failure, ischemic stroke, ischemic heart disease, and peripheral arterial disease.
• Growing evidence supports Lp(a) testing for cardiovascular risk assessment.
• New therapies targeting Lp(a) are emerging, increasing the relevance of its quantification.

Conclusions:

• Lp(a) testing is crucial for identifying individuals at elevated cardiovascular risk.
• Standardized quantification methods and desirable concentration levels are needed.
• Lp(a) determination plays a key role in cardiovascular risk reclassification and personalized treatment strategies.