posted on 2023-06-09, 19:53authored byJaimini Cegla, R Dermot G Neely, Michael France, Gordon FernsGordon Ferns, Chris D Byrne, Julian Halcox, Dev Datta, Nigel Capps, Carol Shoulders, Nadeem Qureshi, Alan Rees, Linda Main, Robert Cramb, Adie Viljoen, Jules Payne, Handrean Soran
Lipoprotein(a), Lp(a), is a modified atherogenic low-density lipoprotein particle that contains apolipoprotein(a). Its levels are highly heritable and variable in the population. This consensus statement by HEART UK is based on the evidence that Lp(a) is an independent cardiovascular disease (CVD) risk factor, provides recommendations for its measurement in clinical practice and reviews current and emerging therapeutic strategies to reduce CVD risk. Ten statements summarise the most salient points for practitioners and patients with high Lp(a). HEART UK recommends that Lp(a) is measured in adults as follows: 1)those with a personal or family history of premature atherosclerotic CVD; 2)those with first-degree relatives who have Lp(a)levels > 200nmol/l; 3) patients with familial hypercholesterolemia; 4) patients with calcific aortic valve stenosis and 5) those with borderline (but<15%) 10 year risk of a cardiovascular event. The management of patients with raised Lp(a) levels should include: 1) reducing overall atherosclerotic risk; 2)controlling dyslipidemia with a desirable nonHDL-cholesterol level of <100mg/d (2.5mmol/l) and 3) consideration of lipoprotein apheresis.