EAS consensus statement on Lp(a) in ASCVD and aortic stenosis
The European Heart Journal has published the 2022 European Atherosclerosis Society consensus statement on Lipoprotein(a) [Lp(a)] in atherosclerotic cardiovascular disease and aortic stenosis.
There is strong evidence for a causal and continuous association between Lp(a) levels and ASCVD, even at low LDL-c levels. Recently, Lp(a) has also been established as a risk factor for aortic valve stenosis. In contrast, there is no evidence of a causal association between Lp(a) and venous thromboembolism. A meta-analysis showed that very low Lp(a) levels may be associated with an increased risk of incident T2DM.
The document provides recommendations for testing and treatment of elevated Lp(a) levels. The authors of the consensus statement recommend testing Lp(a) at least once in adults and Lp(a) levels should be interpreted in the context of absolute global CVD risk. As there are at the moment no approved drugs that specifically lower Lp(a), the authors recommend personalized, early and intensive management of LDL-c, BP, glucose and lifestyle factors to reduce the risk of ASCVD caused by elevated Lp(a) levels. Phase II and III clinical trials with specific Lp(a)-lowering therapies are currently ongoing.