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

Don P Wilson; Terry A Jacobson; Peter H Jones; Marlys L Koschinsky; Catherine J McNeal; Børge G Nordestgaard; Carl E Orringer

doi:10.1016/j.jacl.2019.04.010

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

J Clin Lipidol. 2019 May-Jun;13(3):374-392. doi: 10.1016/j.jacl.2019.04.010. Epub 2019 May 17.

Authors

Don P Wilson¹, Terry A Jacobson², Peter H Jones³, Marlys L Koschinsky⁴, Catherine J McNeal⁵, Børge G Nordestgaard⁶, Carl E Orringer⁷

Affiliations

¹ Department of Pediatric Endocrinology and Diabetes, Cook Children's Medical Center, Fort Worth, TX, USA. Electronic address: [email protected].
² Department of Medicine, Lipid Clinic and Cardiovascular Risk Reduction Program, Emory University, Atlanta, GA, USA.
³ Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
⁴ Robarts Research Institute, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada.
⁵ Division of Cardiology, Department of Internal Medicine, Baylor Scott & White Health, Temple, TX, USA.
⁶ Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.
⁷ Division of Cardiology, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA.

PMID: 31147269
DOI: 10.1016/j.jacl.2019.04.010

Abstract

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.

Keywords: Atherosclerotic cardiovascular disease; Biomarker; Calcific valvular aortic disease; Cardiovascular risk; Coronary heart disease; Cut points; Lifestyle; Lipoprotein (a); Lp(a); Myocardial infarction; Primary prevention; Scientific statement; Secondary prevention; Stroke; Treatment.

MeSH terms

Biomarkers / blood
Blood Chemical Analysis*
Humans
Hypolipidemic Agents / pharmacology
Lipoprotein(a) / blood*
Practice Guidelines as Topic
Societies, Scientific*

Substances

Biomarkers
Hypolipidemic Agents
Lipoprotein(a)