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Updated: Aug 6, 2026

Isolation and Analysis of Plasma Lipoproteins by Ultracentrifugation
06:47

Isolation and Analysis of Plasma Lipoproteins by Ultracentrifugation

Published on: January 28, 2021

Approach to the Patient with Elevated Lipoprotein(a)

Timothy McGinnis1, David R Saxon2,3

  • 1Department of Internal Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.

The Journal of Clinical Endocrinology and Metabolism
|July 16, 2026
PubMed

Insights

Lipoprotein(a) [Lp(a)] is a genetically determined risk factor for cardiovascular disease. Current guidelines recommend Lp(a) screening, with management focusing on optimizing traditional risk factors and emerging therapies.

Area of Science:

  • Cardiology
  • Genetics
  • Lipidology

Background:

  • Lipoprotein(a) [Lp(a)] is a prevalent, genetically determined lipoprotein.
  • Elevated Lp(a) is independently associated with major cardiovascular events like myocardial infarction and stroke.
  • Lp(a) levels are stable and minimally affected by lifestyle, prompting updated screening recommendations.

Purpose of the Study:

  • To highlight the clinical importance of Lipoprotein(a) [Lp(a)].
  • To outline current management strategies for elevated Lp(a).
  • To discuss emerging therapeutic options for Lp(a) lowering.

Main Methods:

  • Review of current guidelines and emerging evidence.
  • Case-based examples for practical risk assessment and management.
  • Discussion of statins, PCSK9 inhibitors, lipid apheresis, and novel therapeutics.

Main Results:

  • The 2026 ACC/AHA/Multisociety Dyslipidemia Guideline recommends one-time Lp(a) measurement for all adults.
  • Current management focuses on aggressive optimization of traditional risk factors, especially LDL-C reduction.
  • Novel Lp(a)-lowering therapies (ASOs, siRNAs) are in Phase 3 clinical trials.

Conclusions:

  • Endocrinologists will frequently manage elevated Lp(a) due to new screening guidelines.
  • No specific Lp(a)-targeting drugs are approved; management relies on risk factor optimization and adjunctive therapies.
  • Emerging therapies show promise for robust Lp(a) reduction, offering future treatment avenues.

Keywords:
Lipoprotein(a)Lp(a)cardiovascular risk

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