Lp(a) is one of the few remaining independent cardiovascular risk factors with no approved targeted therapy, and one that is not yet systematically measured in routine clinical practice. It persists as a driver of cardiovascular events regardless of other risk factors, yet most individuals with elevated Lp(a) remain unaware of their levels.
This Knowledge Track presents key evidence structured around the five clinical decisions that define Lp(a) management today: establishing the causal case, interpreting results in practice, identifying who to test, acting within current options, and understanding emerging Lp(a)-lowering approaches and the evidence informing their development, with each decision connecting evidence directly to clinical application.
Supported by Novartis. Content selected and curated independently by ESC.
START HERE: Understanding lipoprotein(a): A clinical introduction
Lipoprotein(a), or Lp(a), is a largely inherited cardiovascular risk factor that may remain relevant when LDL cholesterol is well controlled. This introduction explains its biological basis, the evidence linking it with cardiovascular disease, and why measurement matters. It provides the foundation for the clinical decisions that follow.
Congress Presentation
Why measure lipoprotein(a)?
30 August 2026 Track introduction: Clinical relevance of Lp(a) and the rationale for testing
Clinical Decision 01: Why does Lp(a) remain relevant when other cardiovascular risk factors are treated?
Lp(a)-associated risk should be considered alongside other cardiovascular risk factors. This section examines evidence from patients receiving optimised statin therapy after acute coronary syndrome, exploring whether Lp(a) remains associated with subsequent events after accounting for smoking, diabetes and other risk factors.
Congress Presentation
Lipoprotein(a), smoking, and diabetes are additive, but not interactive risk factors for major adverse cardiovascular events after acute coronary syndrome: An analysis of the ODYSSEY OUTCOMES trial
31 August 2026 Extended learning: Lp(a)-associated risk after ACS despite optimised statin therapy
Clinical Decision 02: How should Lp(a) results be interpreted? Levels, variability and overall cardiovascular risk
An Lp(a) concentration should be interpreted within the patient’s overall cardiovascular risk. Explore the relationship between concentration and risk, the distinction between absolute and relative risk, and the limitations of individual prediction. Supporting evidence examines measurement variability after acute coronary syndrome and its implications for selected repeat-testing decisions.
Congress Presentation
How to assess risk in the patient with high lipoprotein(a)
30 August 2026 Core learning: Interpreting elevated Lp(a) within overall cardiovascular risk.
Congress Presentation
Variability in lipoprotein(a) measurements in ODYSSEY OUTCOMES: is one-and-done testing sufficient?
31 August 2026 Extended learning: Lp(a) variability and questions about repeat testing after ACS.
Clinical Decision 03: Who should have an Lp(a) test? Screening recommendations and family testing
Review the ESC/EAS recommendations for Lp(a) measurement in adults and the situations in which testing can refine cardiovascular risk assessment. Explore measurement considerations and the rationale for testing relatives. A structured cascade-screening programme illustrates how family testing can identify additional individuals with elevated Lp(a).
Congress Presentation
Prioritise: the importance of lipoprotein(a) testing and treatment optimisation
30 August 2026 Core learning: Lp(a) testing recommendations and implications for prevention
Congress Presentation
LipoaScreen – cascade screening for lipoprotein(a)
1 September 2025 Extended learning: Practical implementation and diagnostic yield of family screening
Clinical Decision 04: How should patients with elevated Lp(a) be managed?
Identifying elevated Lp(a) should prompt a review of the patient’s overall prevention plan. Follow two clinical cases after myocardial infarction or acute coronary syndrome to explore LDL cholesterol lowering, management of other modifiable risk factors and family screening. Real-world registry findings highlight the gap between testing and subsequent treatment intensification.
Congress Presentation
(a)ct today: how elevated lipoprotein(a) is managed today
30 August 2026 Core learning: Case-based management of elevated Lp(a) after myocardial infarction
Congress Presentation
Real world evaluation of lipoprotein (a) testing and impact on LDL-C management in atherosclerotic cardiovascular disease patients: findings from the CVMOBIUS2 registry
30 August 2026 Extended learning: Real-world gaps in testing and treatment intensification
Clinical Decision 05: What can emerging Lp(a)-lowering research tell us?
Explore emerging approaches to targeted Lp(a) lowering and the evidence informing their development. This section examines the effects of lepodisiran on oxidised phospholipids associated with Lp(a), providing insight into its biological activity and the questions that cardiovascular outcomes trials are designed to address.
Congress Presentation
Effect on Oxidized Phospholipids of Lepodisiran, an Extended Duration siRNA Targeting Lipoprotein(a)
31 August 2026 Emerging evidence: Biological effects of targeted Lp(a) lowering. Supporting research on the biological effects of an investigational Lp(a)-lowering therapy.
