Lipoprotein a

1. Lipoprotein a is a molecule produced by the liver, similar to LDL in structure, with a peculiar protein that gives it wide variability.
2. Elevated lipoprotein little (a) is causal of atherosclerotic disease, recurrent strokes, and aortic calcification. Smaller forms of LPa are riskier. LPa is not a risk factor for venous thromboembolism
3. The levels are determined genetically with minimal impact from lifestyle.
4. Normal values are <30mg/dL or <75 nmol/L) Elevated values are >50 mg/dL or >125 nmol/L)
5. Levels should not be converted from mg to mmol or vice versa
6. Levels should be measured once in the lifetime
7. The excess risk of LPa elevation can be mitigated by additional LDL lowering and tighter CV risk factor control.
8. PCSK9i(s) reduces the levels by 25%, but they are not approved for this indication.
9. Aspirin may be beneficial as primary prevention in individuals with genetic variants that elevate LPa.
10. Specific therapies are being developed to lower LPA by >70% and may be released three years from now.