ESC TV Today – Your Cardiovascular News Season 3 - Ep.26: Extended interview on Lp(a) - What to expect in the very near future
Nov 6, 2025
In this insightful discussion, Erik Stroes, an academic clinician from Amsterdam University Medical Center with expertise in lipid disorders, delves into the significance of Lp(a) in cardiovascular health. He highlights how elevated Lp(a) is prevalent yet often overlooked in risk assessments. Erik explains the limited impact of lifestyle changes and current medications on lowering Lp(a), and he emphasizes the need for routine testing to enhance risk prediction. He also shares insights on the clinical significance of Lp(a)-lowering therapies and their prioritization in high-risk patients.
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Lp(a) Is Common And Mostly Genetic
- Lp(a) is highly prevalent: about 1 in 5 people have elevated levels and 1 in 10 have very high levels.
- Lp(a) is largely genetically determined and typically needs only one measurement to classify risk.
When Lp(a) Levels Can Fluctuate
- Lp(a) concentrations are largely stable but can change with specific events like menopause, acute inflammation, or certain drugs.
- Statins may slightly raise Lp(a) and PCSK9 inhibitors lower it by ~20–25%, while infections can transiently raise levels substantially.
Measure Lp(a) Once With First Lipids
- Measure Lp(a) at least once in every patient alongside the first cholesterol test to inform lifetime risk assessment.
- Use that single measurement to tailor prevention strategies rather than relying on repeated tests.