Season 3 - Ep.26: Lp(a): the future starts now - Myocardial infarction in older age and frailty

Nov 6, 2025

Guest

Erik Stroes

Guest

JP Carpenter

Guest

Vijay Kunadian

Erik Stroes, a leading cardiologist from Amsterdam, dives into the intricate biology of Lp(a) and highlights emerging therapies set to transform cardiovascular care. Vijay Kunadian, an expert in treating older and frail patients, discusses nuanced management strategies for myocardial infarction. They debate the importance of screening for Lp(a) and weigh the benefits of invasive versus conservative approaches for older adults. JP Carpenter contributes a witty 'Mythbusters' segment, debunking common beliefs about beetroot’s impact on heart health.

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Episode notes

INSIGHT

Lp(a) Is A Potent, Familial Risk Multiplier

Lp(a) is common, highly atherogenic, and often familial, so a single elevated result suggests family risk.
Its particle effect multiplies existing cardiovascular risk beyond LDL alone.

INSIGHT

Lp(a) Is A Causal Cardiovascular Factor

Mendelian randomization shows Lp(a) is causal, not merely a marker, for atherosclerotic disease.
It both enhances risk and directly mediates atherogenesis and plaque destabilization.

ADVICE

Check Lp(a) Once During Risk Assessment

Measure Lp(a) at least once in everyone assessed for cardiovascular risk since it's genetic and one measurement is sufficient.
Use Lp(a) levels alongside baseline risk to judge clinical relevance, especially above 150 nmol/L.

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This episode covers:

Cardiology this Week: A concise summary of recent studies

Lp(a) - What to expect in the very near future

Myocardial infarction in older and frail adults

Mythbusters: is beetroot good for your heart?

Host: Rick Grobbee

Guests: JP Carpenter, Vijay Kunadian, Erik Stroes

Want to watch that episode? Go to: https://esc365.escardio.org/event/2177

Want to watch that extended interview on Lp(a), go to: https://esc365.escardio.org/event/2177?resource=interview

Disclaimer

ESC TV Today is supported by Bristol Myers Squibb and Novartis through an independent funding.

The programme has not been influenced in any way by its funding partners.

This programme is intended for health care professionals only and is to be used for educational purposes.

The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices.

Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC.

The ESC is not liable for any translated content of this video.

The English language always prevails.

Declarations of interests

Stephan Achenbach, Yasmina Bououdina, Rick Grobbee, Nicolle Kraenkel, Vijay Kunadian and Erik Stroes have declared to have no potential conflicts of interest to report.

Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede.

John-Paul Carpenter has declared to have potential conflicts of interest to report: stockholder MyCardium AI.

Davide Capodanno has declared to have potential conflicts of interest to report: Bristol Myers Squibb, Daiichi Sankyo, Sanofi Aventis, Novo Nordisk, Terumo.

Konstantinos Koskinas has declared to have potential conflicts of interest to report: honoraria from MSD, Daiichi Sankyo, Sanofi.

Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada.

Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.