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Guidelines and Lp(a)
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Adult Guidelines


NHLBI & ACC/AHA - Oct 2015

  • States that elevated levels of Lp(a) are associated with an increased risk for premature ASCVD, and are largely genetically determined.

2013 Report on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Disease in Adults: Full Panel Report Supplement


ESC/EAS - Aug 2016


  • Lipoprotein(a) is a low-density lipoprotein to which an additional protein called apolipoprotein(a) is attached.
  • High concentrations of Lp(a) are associated with increased risk of CAD and ischemic stroke and Mendelian randomization studies support a causal role in CVD for Lp(a).
  • At present there is no justification for screening the general population for Lp(a), but it may be considered in patients at moderate risk to refine risk evaluation or in subjects with a family history of early CVD.


Catapano, et al. European Heart Journal (2016) DOI: ehw272 First published online: 27 August 2016


NLA - 2011

  • Recognizes Lp(a) as independent, additive contributor to Cardiovascular risk.
  • Recommends Lp(a) testing in patients with a family history of premature Coronary Artery Disease (CAD) or with established Coronary Heart Disease (CHD) with a history of recurrent events despite appropriate therapy.

Davidson et al, Journal of Clinical Lipidology (2011) 5, 338–367



Pediatric Guidelines Dec 2011 
2011 Dec;128 Suppl 5:S213-56. doi: 10.1542/peds.2009-2107C. Epub 2011 Nov 14.


Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report.


In terms of other lipid measurements, (1) most but not all studies have found that measurement of apolipoprotein B and apolipoprotein A-1 for universal screening provides no additional advantage over measuring non-HDL cholesterol, LDL cholesterol, and HDL cholesterol levels, (2) measurement of lipoprotein(a) is useful in the assessment of children with both hemorrhagic and ischemic stroke, (3) in offspring of a parent with premature CVD and no other identifiable risk factors, elevations of apolipoprotein B, apolipoprotein A-1, and lipoprotein(a) have been noted, and (4) measurement of lipoprotein subclasses and their sizes by advanced lipoprotein testing has not been found to have sufficient clinical utility in children at this time (grade B).


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