Use of Lipoprotein(a) in clinical practice: A biomarker whose time has come. A scientific statement from the National Lipid Association

• Published in: Journal of clinical lipidology Vol. 13; no. 3; pp. 374 - 392
• Main Authors: Wilson, Don P., Jacobson, Terry A., Jones, Peter H., Koschinsky, Marlys L., McNeal, Catherine J., Nordestgaard, Børge G., Orringer, Carl E.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2019
• Subjects: Atherosclerotic cardiovascular disease; Biomarker; Biomarkers - blood; Blood Chemical Analysis; Calcific valvular aortic disease; Cardiovascular risk; Coronary heart disease; Cut points; Humans; Hypolipidemic Agents - pharmacology; Lifestyle; Lipoprotein (a); Lipoprotein(a) - blood; Lp(a); Myocardial infarction; Practice Guidelines as Topic; Primary prevention; Scientific statement; Secondary prevention; Societies, Scientific; Stroke; Treatment; Myocardial infarction; Biomarker; Stroke; Atherosclerotic cardiovascular disease; Coronary heart disease; Lp(a); Treatment; Calcific valvular aortic disease; Primary prevention; Cardiovascular risk; Scientific statement; Secondary prevention; Lifestyle; Cut points; Lipoprotein (a)
• ISSN: 1933-2874; 1876-4789
• DOI: 10.1016/j.jacl.2019.04.010

Lipoprotein(a) [Lp(a)] is a well-recognized, independent risk factor for atherosclerotic cardiovascular disease, with elevated levels estimated to be prevalent in 20% of the population. Observational and genetic evidence strongly support a causal relationship between high plasma concentrations of Lp(a) and increased risk of atherosclerotic cardiovascular disease–related events, such as myocardial infarction and stroke, and valvular aortic stenosis. In this scientific statement, we review an array of evidence-based considerations for testing of Lp(a) in clinical practice and the utilization of Lp(a) levels to inform treatment strategies in primary and secondary prevention. •Causal association between high lipoprotein(a) [Lp(a)] and atherosclerotic cardiovascular disease–related events and mortality.•Laboratory methods and population-based considerations for Lp(a) cut points.•When to measure Lp(a) in adults and youth.•Treatment implications in primary and secondary prevention.