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Current Cardiology Reports

Lp(a): Global Public Health Concern: Emerging Knowledge and Therapeutic Approaches

  • 01-12-2025
  • Public Health
  • Global Cardiovascular Health (L Sperling and D Gaita, Section Editors)
Published in:
Authors
Alexander C. Razavi
Jessica Hong
Harpreet S. Bhatia
Published in
Current Cardiology Reports | Issue 1/2025

Abstract

Purpose of Review

Lipoprotein(a) [Lp(a)] is an apolipoprotein B-containing lipoprotein that is a genetic causal risk factor for atherosclerotic cardiovascular disease (ASCVD) and calcific aortic valve disease. This review focuses on new findings and treatment approaches for individuals with elevated Lp(a) across the spectrum of ASCVD.

Recent Findings

One in five individuals globally have elevated Lp(a) (> 125 nmol/L or > 50 mg/dL). Emerging knowledge related to Lp(a) includes demonstration of poor rates of Lp(a) testing, comparison of methods for Lp(a) measurement, natural variability in Lp(a) levels, the continuous association between Lp(a) and ASCVD risk, atherogenicity in comparison with LDL, risk in context of other risk factors, coronary plaque characteristics, and the association of Lp(a) with a broader range of outcomes. Optimal risk factor control, including LDL-cholesterol lowering, is a cornerstone of management. When indicated, shared decision-making to discuss antiplatelet therapy for individuals with very-high Lp(a) may also be helpful. Several Lp(a)-lowering therapies are under investigation in ASCVD outcome trials.

Summary

While Lp(a) is a well-established risk factor for ASCVD, there are several areas of growing knowledge related to Lp(a), and management strategies of individuals with elevated Lp(a) continue to evolve with targeted therapies currently in late-stage clinical trials.
Title
Lp(a): Global Public Health Concern: Emerging Knowledge and Therapeutic Approaches
Authors
Alexander C. Razavi
Jessica Hong
Harpreet S. Bhatia
Publication date
01-12-2025
Publisher
Springer US
Keyword
Public Health
Published in
Current Cardiology Reports / Issue 1/2025
Print ISSN: 1523-3782
Electronic ISSN: 1534-3170
DOI
https://doi.org/10.1007/s11886-025-02255-2
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Image Credits
Abstract graphic of layered, concentric circular shapes in bright green, pink, blue, and purple on a dark blue background. The rings and segments form a complex radial pattern without text/© Springer Health+ IME