Quick Facts

• 20-30% of people worldwide have elevated lipoprotein(a) levels that double heart disease risk
• 95% of Americans have never been screened for this genetic risk factor despite simple testing
• Five new treatments in development could reduce lipoprotein(a) levels by up to 100% by 2026

A blood test that measures lipoprotein(a) can predict heart disease risk years in advance, yet 95% of Americans have never been screened for this common genetic risk factor.

Lipoprotein(a), or Lp(a), affects one in five people worldwide. Levels of 125 nmol/L or higher increase heart disease and stroke risk. Levels of 250 nmol/L or higher double that risk.

The Family Heart Foundation presented new data on 392,835 Americans at the American Heart Association Scientific Sessions in Chicago. This represents one of the largest analyses of US lipoprotein(a) data to date.

“Almost everyone is familiar with getting screened for high cholesterol, yet 95% of the population has never been screened for high Lp(a),” researchers found. Only 1.1% of adults were screened between 2012 and 2021.

The screening gap persists despite clear risk data. Patients with Lp(a) levels of 14.8 to 66 mg per dL showed a 24% increased risk of death from coronary artery disease compared to those in the lowest quartile. Those with levels above 66 mg per dL had a 33% higher risk.

Current Testing Guidelines Vary by Region

In the United States, Lp(a) testing is recommended for people under 65 who have had heart attacks, those with family history of early heart disease, and patients with high LDL cholesterol who don’t respond to statins.

Europe and Canada recommend Lp(a) screenings for everyone.

“Elevated Lp(a) affects one in five individuals, yet unfortunately, most of those individuals are undiagnosed,” said Dr. Julie Clary, Vice Chair for Clinical Affairs at Indiana University Health. “Not knowing you have a condition is not the same as not having that condition.”

New Treatments Show Promise

Five revolutionary treatments are in development to target Lp(a) reduction. Small interfering RNA therapies including pelacarsen, olpasiran, and lepodisiran have shown 80% to nearly 100% reductions in Lp(a) levels in phase 2 trials.

The oral medication muvalaplin reduces Lp(a) by up to 65% with once-daily dosing.

Phase 3 cardiovascular outcome studies for several treatments are underway. The largest study, ACCLAIM-Lp(a), will include 16,700 patients. First results may be available in 2026.

“I tell them that by the time your 7-year-old has to worry about this, we’ll have a way to treat it,” said Dr. Sotirios Tsimikas, an Lp(a) researcher at the University of California San Diego, speaking to parents of children with elevated levels.

Lipoprotein(a) is genetically determined and cannot be lowered through diet or exercise alone, making pharmaceutical intervention necessary for high-risk patients.

Read more: This Blood Test Helps Predict Your Heart Disease Risk