Study showed that every increase in Lp(a) is associated with increased risk of a cardiovascular event; individuals with the highest levels (>300 nmol/L) were 40% more likely to have a cardiovascular event compared to people at lower levels (<15 nmol/L).
Study also demonstrated that treatment with high impact LDL-C lowering therapies may diminish the risk of recurrent cardiovascular events due to increased Lp(a).
Results presented today at European Atherosclerosis Society Congress in Glasgow and simultaneously published in the European Heart Journal.
GLASGOW, SCOTLAND (May 7, 2025) – The Family Heart Foundation, a leading research and advocacy organization focused on the role of lipids in cardiovascular disease and prevention, today announced results from the largest study ever conducted of people living with cardiovascular disease who have a confirmed measurement of lipoprotein(a), also known as Lp(a). Results showing that any increase in levels of Lp(a) is associated with increased risk of cardiovascular events including heart attack and stroke were presented today at the European Atherosclerosis Society Congress in Glasgow Scotland and were simultaneously published in the peer-reviewed European Heart Journal.
"While previous smaller studies have shown that the risk of cardiovascular events can increase within certain ranges of Lp(a), this is the first study to show that the risks of cardiovascular events including heart attack, stroke and cardiac surgeries continue to increase across all ascending levels of Lp(a) and that there is no indication that the risk plateaus," said Katherine Wilemon, founder and chief executive officer of the Family Heart Foundation. "The US has lagged behind many other countries in recommending that adults complete a simple blood test to measure Lp(a). This study strongly confirms the importance of considering Lp(a) levels among other risk factors when determining an individual's risk of future heart attacks and strokes."
The study followed the health histories of a diverse population of 273,770 US individuals with atherosclerotic cardiovascular disease (ASCVD) for a median 5.4 years to determine whether they had another cardiovascular event such as myocardial infarction or ischemic stroke, or a procedure such as percutaneous coronary intervention or coronary artery bypass graft. Within the study population overall, about 33% had low levels of Lp(a) (<15 nmol/L), 33% had moderate levels (15-79 nmol/L), 15% had moderate-to-high levels (80-179 nmol/L), 10% had levels considered high (180-299 nmol/L) and 5% had levels considered very high (³300 nmol/L). This study is the first to show that the risk of a subsequent cardiovascular event rises continually as lipoprotein(a) increases from any level. The study also shows that women and Black individuals are more likely to have elevated Lp(a) levels.
"Among the many important findings in this study, we now know that in people living with cardiovascular disease every nmol/L of Lp(a) confers increased risk of a subsequent cardiovascular event. This is a meaningful advancement in our understanding of the impact of Lp(a) on one's health," said Diane MacDougall, Vice President, Science and Research, Family Heart Foundation, and first author of the study. "The results further show that the risk increases regardless of what type of cardiovascular disease individuals had initially (in the heart, brain or legs), whether or not they also had diabetes, or their sex or race/ethnicity. The higher the Lp(a) level, the more likely people living with ASCVD are to have another cardiovascular event."
While several investigational drugs are undergoing late-stage testing, currently no drugs are approved to help reduce levels of Lp(a). This study included an analysis to determine whether efforts to manage LDL-C in people with high Lp(a) could be beneficial. Results showed that among people with ASCVD and Lp(a) levels ³180 nmol/L, the risk of having another cardiovascular event appears to be diminished by using high impact LDL-C lowering drugs such as high dose statin and PCSK9 inhibitors compared with using lower impact LDL-C lowering drugs or using no drugs.
Results of the study were presented today by Professor Børge Nordestgaard, MD, DMSc, President of the European Atherosclerosis Society, in an oral presentation at the European Atherosclerosis Society Congress, and were published simultaneously in the peer-reviewed European Heart Journal by lead author Diane MacDougall, et al. The data were drawn from the Family Heart Database®, a real-world database that includes medical claims from 340 million US individuals between 2012-2022. The database is managed by the Family Heart Foundation to characterize patterns of real-world medical encounters by US individuals with lipid disorders and cardiovascular risk.
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