Abstract
Lipoprotein(a), or Lp(a), is a unique lipoprotein demonstrated to be a risk factor for atherosclerotic cardiovascular disease (ASCVD) and calcific aortic valve stenosis. Lp(a) is a genetic risk factor not responsive to changes in environment, lifestyle, or physiological conditions. Lp(a) serum concentrations >= 125 nmol/L are associated with increased ASCVD risk, but this threshold is not universally accepted. None of the available lipid-lowering drugs are indicated for the treatment of elevated Lp(a). There are currently four investigational RNA-based therapeutic agents that have substantially reduced Lp(a) in clinical trials; two of them are being evaluated for ASCVD risk reduction in adequately powered outcomes studies. Until agents specifically targeting elevated Lp(a) become available, intensive risk-factor modification is the general management strategy.