A new drug called lepodisiran may offer hope to millions of people at risk of heart attacks and strokes by targeting a little-known substance in the blood.
The drug, developed by pharmaceutical company Eli Lilly, dramatically lowered levels of a harmful particle known as Lp(a) in a recent study. Just one injection cut Lp(a) by 94%, and the effects lasted for six months without major side effects.
Lp(a), or lipoprotein(a), is a mix of fat and protein found in the blood. High levels of Lp(a) are mostly caused by genetics and can’t be lowered by diet, exercise, or lifestyle changes. Yet, many people with high Lp(a) don’t know they have it, because most doctors don’t test for it.
Studies suggest that around 1 in 5 Americans—about 64 million people—have high Lp(a) levels. This raises their risk of heart attacks and strokes, even if other risk factors like cholesterol and blood pressure are normal.
This new research was presented at a major heart conference in Chicago and published in the New England Journal of Medicine. Although lepodisiran’s ability to reduce Lp(a) is clear, it’s still unknown whether that reduction will lead to fewer heart attacks and strokes.
Larger trials are underway to answer that question. One of them, led by Dr. Steven Nissen of the Cleveland Clinic, will run until 2029. Results from a similar drug by Novartis could come as soon as next year.
Lp(a) was discovered in 1974 and has long puzzled doctors. It behaves differently than LDL, or “bad” cholesterol. While LDL levels can be managed with diet, exercise, and medications like statins, Lp(a) is controlled almost entirely by your genes. That means even young or seemingly healthy people can have dangerously high levels without knowing it.
Dr. Nissen says that Lp(a) may be the hidden reason behind heart attacks in people who otherwise seem low risk. “If you go into the coronary care unit and see someone who is 40 years old with a heart attack, you need to know the level of their Lp(a),” he told The New York Times.
Other heart experts agree. Dr. David Maron, a cardiologist at Stanford who wasn’t involved in the study, described the new drug’s results as “thrilling.” He believes they show strong potential, especially because lepodisiran’s effects last so long after just one dose.
Dr. Martha Gulati, a cardiologist at Cedars-Sinai Medical Center, pointed out another concern: most people aren’t tested for Lp(a), even though it’s covered by insurance. One study showed that fewer than 1% of Americans have ever had an Lp(a) test.
Among people with heart disease, only 3% have been tested. Because Lp(a) levels don’t change over time, Dr. Gulati believes every adult should be tested at least once to assess their risk.
There are real-life examples that highlight the danger of high Lp(a). Monte Wooden, a 71-year-old man who had a heart attack in 2006, had no typical risk factors—he didn’t smoke and had normal blood pressure.
But doctors later discovered that his Lp(a) level was over 400, far above the normal limit of 75. When he took part in a clinical trial and received medication, his symptoms went away. But after the trial ended, the symptoms returned, and he eventually needed a quadruple bypass surgery.
Stories like Monte’s suggest that lowering Lp(a) could make a difference. While these stories are anecdotal and not scientific proof, they offer a glimpse into how this new class of drugs might help prevent heart attacks in people who are currently overlooked.
Review and Analysis of the Study
This study highlights a major advance in cardiovascular medicine. Lepodisiran appears to be a powerful way to lower Lp(a), a genetic risk factor that has been difficult to treat until now. The 94% drop in Lp(a) levels from a single injection is remarkable, and the fact that it lasts for six months could make treatment easier and more convenient for patients.
One of the most important parts of this research is that it brings attention to Lp(a), a factor that many people and even doctors don’t consider. While LDL cholesterol has long been the focus of heart disease prevention, Lp(a) might be just as important—especially for people who suffer heart attacks at a young age or without other risk factors.
However, the research is still in its early stages. We don’t yet know whether lowering Lp(a) will actually prevent heart attacks and strokes.
That’s why the ongoing larger trials are so important. If the results show that reducing Lp(a) truly lowers risk, it could lead to a new wave of personalized heart disease treatment—especially for those whose Lp(a) levels are dangerously high and unresponsive to current therapies.
For now, the key takeaway is that Lp(a) matters, and more people should know their levels. With promising drugs like lepodisiran in development, testing for Lp(a) could become a vital step in protecting millions of people from sudden and unexpected heart disease.
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The research findings can be found in the New England Journal of Medicine.
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