In a REDUCE-IT substudy, icosapent ethyl had little to no effect on biomarkers associated with atherosclerotic disease, such as IL-1β, IL-6, oxidized LDL-c, and Lp(a). However, mineral oil increased these levels.

AHA 2022 The phase 2 OCEAN(a)-DOSE study showed that olpasiran dosed 75 mg or higher every 12 weeks reduces Lp(a) by >95% in patients with elevated Lp(a) and established ASCVD.

The importance of measuring Lp(a) has been established. The next big question is: will we be able to attenuate Lp(a)-associated risk?

Prof. Kronenberg talks about the importance of measuring Lp(a) levels. He also discusses the challenges in determining Lp(a), the rationale for risk thresholds and whether genetic testing is necessary.

How can we make the best choices for optimal, affordable and sustainable care for patients with high CV risk due to multiple risk factors? Prof. Stroes illustrates the challenge of choosing.

Pia Kamstrup gives an overview of studies on Lp(a)-associated risk. She shows that elevated Lp(a) levels are associated with CVD and aortic valve stenosis, and that Lp(a)-associated risk is independent of other risk factors.

The Journal of the European Heart Journal has published the 2022 European Atherosclerosis Society consensus statement on Lp(a) in atherosclerotic cardiovascular disease and aortic stenosis.

EAS 2022 "According to [these] data, there is no reason why you should give aspirin to an individual with high Lp(a)," says prof. Catapano. He recapitulates the findings of a study by Olmastroni and colleagues.

EAS 2022 It is recommended that risk factors, such as LDL-c, should be controlled in patients with high Lp(a) levels. Prof. Catapano briefly summarizes the findings of a study on this topic that was presented at EAS 2022.

EAS 2022 Thus far there is no effective therapy to reduce Lp(a) levels. Risk factor modification is recommended for persons with high Lp(a), but how much LDL-c lowering is needed to overcome the increased ASCVD risk caused by high Lp(a)?

EAS 2022 A study found that Lp(a) is not associated with VTE and the increased risk of MI caused by high Lp(a) levels is unlikely to be decreased by antiplatelet or antithrombin therapy.

Lp(a) levels are thought to stay stable over time, at least in adults. As several lipid values change during childhood, Lp(a) values were measured in a large cohort of children. The result: Lp(a) levels increased with age.