Lipoprotein(a): An important piece of the ASCVD risk factor puzzle across diverse populations

Figures

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  Fig. 1. Structure of Lp(a), and Lp(a)-attributable ASCVD risk categories [2]. apoB – apolipoprotein B100, CV – cardiovascular, KIV – kringle IV, KV – kringle V, Lp(a) – lipoprotein(a), OxPL – oxidized phospholipid, P – protease; s-s – disulfide.

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  Fig. 2. Summary of the key benefits of Lp(a) testing and practical points [1,2,5,17,26]. ASCVD – atherosclerotic cardiovascular disease, CV – cardiovascular, CVD – cardiovascular disease, Lp(a) – lipoprotein(a). *Clinical assays that report Lp(a) concentrations in nmol/L are preferred over those that report in mg/dL. Due to substantial variation in assays, it is not recommended to directly convert between nmol/L and mg/dL; a conversion factor of 2.5 from mg/dL to nmol/L provides an approximation only [2]; †Non-genetic factors such as kidney disease may affect Lp(a) measurement and may necessitate repeat testing in select patients. Repeat testing may also be beneficial in post-menopausal women. In addition, repeat testing may be required if/when Lp(a)-lowering therapies become available in order to assess treatment response.

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  Fig. 3. Proposed solutions for common barriers to Lp(a) testing [1,2]. CVD – cardiovascular disease, HCP – healthcare professional, ICD – International Classification of Diseases, Lp(a) – lipoprotein(a).