Overview
- An analysis in JAMA Cardiology of 27,748 participants in the Women’s Health Study followed for up to 30 years found baseline Lp(a) levels predicted major cardiovascular events and coronary heart disease.
- Risk increased only above about 30 mg/dL (around the 75th percentile), with the top percentile near 131 mg/dL linked to roughly a 74% higher long-term cardiovascular risk versus below-median levels.
- Extremely high concentrations above 120 mg/dL or in the top ~1% were associated with nearly double coronary heart disease risk and a higher likelihood of cardiovascular death, with ischemic stroke risk rising mainly at these extremes.
- A genotype analysis showed carriers of the LPA rs3798220 variant among women of European ancestry had substantially higher median Lp(a) and an elevated 10-year event risk, aligning with observed risk estimates.
- The authors advocate targeted screening to flag severely elevated Lp(a) for intensified prevention and potential future therapies, noting current guidelines are inconsistent and outcome-proven Lp(a)-lowering treatments are not yet established.