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Purpose of Review <p>This review characterizes atherosclerotic cardiovascular disease (ASCVD) risk associated with Lipoprotein(a) [Lp(a)], with a focus on current and emerging therapeutic strategies for individuals with elevated Lp(a).</p> Recent Findings <p>Though Lp(a) is predominantly genetically inherited, optimization of risk factors, healthy lifestyle, and statin therapy are associated with a lower risk of ASCVD in those with elevated Lp(a). Observational research and post-hoc analyses suggest that aspirin use may be associated with lower ASCVD risk among individuals with elevated Lp(a), supporting an individualized, shared decision-making approach that considers bleeding risk, overall cardiovascular risk profile, and additional markers of cardiovascular risk. Post-hoc analyses of randomized controlled trials demonstrate that individuals with elevated Lp(a) are more likely to benefit from PCSK9 inhibitors compared to those with normal Lp(a), as PCSK9 inhibitors lead to an approximate 20–25% lowering of Lp(a). There are several ongoing Phase 3 ASCVD outcome trials assessing dedicated Lp(a)-lowering therapies, with the earliest, Lp(a) HORIZON, projected to be reported in 2026.</p> Summary <p>Early identification of individuals with high Lp(a) may improve personalized risk stratification and targeted interventions for ASCVD risk reduction.</p>

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Lipoprotein(a) in Cardiovascular Disease Prevention: Current and Emerging Therapeutic Approaches

  • 期刊论文

  • 发表日期：

    2026年7月16日

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  • Jeffery Osei,
  • Josiah Bennett,
  • Om Raval,
  • Grace Seo,
  • Scott D. Eisenberg,
  • Rachel Nyenhuis,
  • Gabrielle Gershon,
  • Samuel Stresemann,
  • Sueda Akkaya,
  • Anushua Bhattacharya,
  • Alexander C. Razavi,
  • Anurag Mehta,
  • Laurence S. Sperling

摘要

Purpose of Review

This review characterizes atherosclerotic cardiovascular disease (ASCVD) risk associated with Lipoprotein(a) [Lp(a)], with a focus on current and emerging therapeutic strategies for individuals with elevated Lp(a).

Recent Findings

Though Lp(a) is predominantly genetically inherited, optimization of risk factors, healthy lifestyle, and statin therapy are associated with a lower risk of ASCVD in those with elevated Lp(a). Observational research and post-hoc analyses suggest that aspirin use may be associated with lower ASCVD risk among individuals with elevated Lp(a), supporting an individualized, shared decision-making approach that considers bleeding risk, overall cardiovascular risk profile, and additional markers of cardiovascular risk. Post-hoc analyses of randomized controlled trials demonstrate that individuals with elevated Lp(a) are more likely to benefit from PCSK9 inhibitors compared to those with normal Lp(a), as PCSK9 inhibitors lead to an approximate 20–25% lowering of Lp(a). There are several ongoing Phase 3 ASCVD outcome trials assessing dedicated Lp(a)-lowering therapies, with the earliest, Lp(a) HORIZON, projected to be reported in 2026.

Summary

Early identification of individuals with high Lp(a) may improve personalized risk stratification and targeted interventions for ASCVD risk reduction.