Unveiling Hidden Risks: The Case for Lp(a) Testing

EP: 1.Decoding Atherogenic Lipoproteins: Unraveling the Role of LDL and Lp(a)

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EP: 2.Unveiling Hidden Risks: The Case for Lp(a) Testing

EP: 3.Lp(a) Genetic Patterns

EP: 4.Insights From the Lp(a) HERITAGE Study

EP: 5.Lp(a) Ethnicity and Gender Risks

EP: 6.Unveiling Cardiovascular Disparities in Lp(a)

EP: 7.Lp(a) Screening in ASCVD: Clinical Integration

EP: 8.Integration of Lp(a)Testing Across Health Care Organizations

EP: 9.A Look to The Future of Lp(a) Management

EP: 10.Actionable Insights for Health Care Decision Makers on Lp(a) Testing

Michael D. Shapiro, DO, addressed the differences between guidelines on Lp(a) (lipoprotein a) testing. The National Lipid Association's 2019 scientific statement recommends Lp(a) screening in familial hypercholesterolemia, those with a history of premature atherosclerotic cardiovascular disease, and when considering PCS-K9 inhibitor therapy. In contrast, the 2018 ACC-AHA guidelines view Lp(a) as a risk enhancer, suggesting statin therapy consideration when elevated.

Discussing the 2019 ASC [Ambulatory Surgical Center] and EAS [European Atherosclerosis Society] guidelines, Shapiro highlighted the recommendation to measure Lp(a) once in an individual's lifetime. These guidelines emphasize Lp(a)'s causal role in atherosclerotic cardiovascular disease and its value in refining risk assessment. Individuals with moderately high low-density lipoprotein (LDL) cholesterol but significantly elevated Lp(a) face heightened atherosclerotic cardiovascular disease (ASCVD) risk, warranting intensified preventive strategies.

Regarding clinical integration, Shapiro highlighted the trend towards universal Lp(a) screening in adults as per 2021 Canadian guidelines and the 2022 EAS/ESC recommendations. Identifying Lp(a)'s prevalence among 20% of the global population underscores the need for widespread testing to reclassify risk and adopt a personalized prevention approach. Initiating cascade testing for first-degree relatives after identifying elevated LPA in an index patient ensures comprehensive risk assessment and targeted preventive measures for those at risk of cardiovascular disease.

This summary was AI-generated and reviewed by an AJMC editor.