The Family Heart Foundation recently released findings from the largest study ever conducted on people living with cardiovascular disease who had their lipoprotein(a) levels, or Lp(a), measured. The results were presented at the European Atherosclerosis Society Congress in Glasgow, Scotland, and published in the European Heart Journal.
The study confirmed that any increase in Lp(a) levels is directly linked to a higher risk of cardiovascular events such as heart attacks, strokes, and even cardiac surgeries. This discovery is significant because it shows that the risk does not level off at any point—it just keeps climbing as Lp(a) levels go up.
Lipoprotein(a), or Lp(a), is a type of cholesterol that is known to contribute to the buildup of plaque in arteries, leading to atherosclerosis, which increases the risk of heart-related events. While earlier studies hinted that elevated Lp(a) levels could be risky, this research is the first to clearly demonstrate that the risk keeps rising at every level of Lp(a) without any sign of a plateau.
Katherine Wilemon, the founder and CEO of the Family Heart Foundation, emphasized that the United States has been slower than other countries in recommending routine Lp(a) testing for adults. She believes this study is a strong call to action for making Lp(a) testing a standard part of cardiovascular risk assessment.
The study monitored the health histories of 273,770 people in the United States with atherosclerotic cardiovascular disease (ASCVD) for an average of 5.4 years.
Researchers tracked who experienced a second cardiovascular event, such as a heart attack or stroke, or needed procedures like stent placements or bypass surgeries. The participants were divided into groups based on their Lp(a) levels:
- Low Lp(a) levels (<15 nmol/L) – 33% of participants
- Moderate Lp(a) levels (15–79 nmol/L) – 33% of participants
- Moderate-to-high Lp(a) levels (80–179 nmol/L) – 15% of participants
- High Lp(a) levels (180–299 nmol/L) – 10% of participants
- Very high Lp(a) levels (³300 nmol/L) – 5% of participants
The study’s major finding was that the risk of experiencing another cardiovascular event increased steadily with higher Lp(a) levels. This was true regardless of the type of cardiovascular disease they had initially—whether it was heart-related, brain-related, or affecting the legs.
The findings also showed that women and Black individuals were more likely to have elevated Lp(a) levels, making them particularly vulnerable to repeat heart attacks or strokes.
Diane MacDougall, vice president of science and research at the Family Heart Foundation and the first author of the study, said the results are a meaningful step forward in understanding how Lp(a) contributes to cardiovascular risk.
She explained that this risk applies across all types of cardiovascular diseases, regardless of a person’s race, gender, or whether they also have diabetes.
The study also explored whether lowering LDL cholesterol (LDL-C) could help people with high Lp(a) levels. LDL-C is often called “bad cholesterol” because it contributes to plaque buildup in arteries.
The researchers found that using strong LDL-C-lowering medications like high-dose statins and PCSK9 inhibitors appeared to reduce the risk of another cardiovascular event in people with Lp(a) levels above 180 nmol/L. These medications were more effective than milder cholesterol-lowering drugs or no treatment at all.
Currently, there are no approved medications specifically designed to lower Lp(a) levels. However, several experimental drugs are in the final stages of testing. If successful, these drugs could be the first to specifically target Lp(a) and potentially reduce the risk of heart attacks and strokes for millions of people with high Lp(a) levels.
This study underlines the importance of testing for Lp(a) as part of routine health screenings, especially for people with cardiovascular conditions. The fact that the risk of heart attacks and strokes continues to climb with every increase in Lp(a) suggests that keeping an eye on these levels could be crucial for better heart health.
As new treatments are developed, there is hope that managing Lp(a) might soon become a more accessible and effective way to prevent serious heart problems.
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The research findings can be found in European Heart Journal.
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