Lp(a): A Toolkit for Health Care Professionals

5 Lp(a) at a Glance z Lp(a) is independently associated with ASCVD. z Lp(a) levels are established in early childhood and remain relatively consistent over an individual’s lifetime. z Lp(a) is composed of apolipoprotein(a) [apo(a)] covalently bound to an apolipoprotein B (apoB)-100-containing lipoprotein particle. z Although some evidence is conflicting, Lp(a) seems to increase cardiovascular risk through multiple mechanisms, including those attributable to both its LDL-like moiety as well as the unique apo(a) protein. The latter may confer prothrombotic and additional proinflammatory effects that can cause vascular cell dysfunction. 4 z Elevated Lp(a) is associated with heightened risk for myocardial infarction, ischemic stroke and enhanced peripheral artery disease. 5 z Other factors that influence Lp(a) levels include age, sex, ethnicity 12 and comorbid conditions, such as familial hypercholesterolemia 8 and liver or kidney disease. z Distribution of Lp(a) levels may vary by population-specific percentiles due to differences in the distribution of Lp(a) levels among ethnic groups. It’s also affected by certain disease conditions. 6 z Despite the positive effects of diet and exercise in preventing cardiovascular disease, the two don’t reduce Lp(a) levels. 9 z Statins are ineffective in reducing Lp(a). To the contrary, although not well appreciated, research shows statins can increase Lp(a) levels, on average, by approximately 10%-50%. 10 Up to90% of Lp(a) plasma concentration is determined by genetics 6,7 Other factors that influence Lp(a) levels include age, sex, ethnicity 12 and comorbid conditions, such as familial hypercholesterolemia 8 and liver or kidney disease.