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Purpose of Review <p>To critically evaluate the latest evidence on Lipoprotein a [Lp(a)], summarize current recommendations from professional societies, and highlight advances in therapeutic development. We also aim to identify controversies, persisting knowledge gaps, and the future directions necessary to improve patient care.</p> Recent Findings <p>Lp(a) is a genetically determined, proatherogenic, and prothrombotic lipoprotein that contributes substantially to cardiovascular risk. International guidelines increasingly endorse broader screening approaches, novel therapeutic agents specifically targeting Lp(a) are under active investigation, and new evidence has emerged to integrate to cardiovascular risk assessment.</p> Summary <p>Individuals with elevated Lp(a) remain at heightened residual cardiovascular risk despite optimal management of traditional risk factors. While promising advances are underway, key questions remain about the long-term clinical efficacy, safety, and cost-effectiveness of novel therapies. Moving forward, aligning guideline implementation, advancing therapeutic innovation, and closing knowledge gaps will be essential to translate scientific progress into meaningful reductions in Lp(a)-mediated cardiovascular disease. The integration of Lp(a) for improved cardiovascular risk assessment is of great importance, current therapies are limited, but modifiable risk factors remain a cornerstone. It remains to be seen how novel therapies will translate into long-term outcomes and whether they will prove cost-effective. This review aims to elucidate the latest research on Lp(a) while highlighting its impact on systemic atherosclerotic disease, summarizing current societal recommendations, exploring emerging therapies, highlighting controversies and gaps in knowledge, and providing future perspectives.</p>

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Lipoprotein(a) and Cardiovascular Risk: Current Evidence, Clinical Application, and Future Directions

  • 期刊论文

  • 发表日期：

    2025年12月3日

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  • Carlos A. Vergara Sanchez,
  • Rodolfo A. Lopes,
  • Michael D. Shapiro

摘要

Purpose of Review

To critically evaluate the latest evidence on Lipoprotein a [Lp(a)], summarize current recommendations from professional societies, and highlight advances in therapeutic development. We also aim to identify controversies, persisting knowledge gaps, and the future directions necessary to improve patient care.

Recent Findings

Lp(a) is a genetically determined, proatherogenic, and prothrombotic lipoprotein that contributes substantially to cardiovascular risk. International guidelines increasingly endorse broader screening approaches, novel therapeutic agents specifically targeting Lp(a) are under active investigation, and new evidence has emerged to integrate to cardiovascular risk assessment.

Summary

Individuals with elevated Lp(a) remain at heightened residual cardiovascular risk despite optimal management of traditional risk factors. While promising advances are underway, key questions remain about the long-term clinical efficacy, safety, and cost-effectiveness of novel therapies. Moving forward, aligning guideline implementation, advancing therapeutic innovation, and closing knowledge gaps will be essential to translate scientific progress into meaningful reductions in Lp(a)-mediated cardiovascular disease. The integration of Lp(a) for improved cardiovascular risk assessment is of great importance, current therapies are limited, but modifiable risk factors remain a cornerstone. It remains to be seen how novel therapies will translate into long-term outcomes and whether they will prove cost-effective. This review aims to elucidate the latest research on Lp(a) while highlighting its impact on systemic atherosclerotic disease, summarizing current societal recommendations, exploring emerging therapies, highlighting controversies and gaps in knowledge, and providing future perspectives.