Key result
Multimodal ASCVD risk assessment integrating Lp(a), imaging, and genetics provides actionable phenotypes for preventive therapy.
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Provides a practical framework integrating Lp(a), risk equations, imaging, and genetics to refine ASCVD risk assessment and guide preventive therapy intensity.
Purpose of Review Elevated lipoprotein(a) [Lp(a)] is a common, causal risk factor for atherosclerotic cardiovascular disease (ASCVD). Clinicians continue to face questions regarding how overall risk should be refined once Lp(a) is identified. Recent Findings International guidelines are beginning to universally recommend Lp(a) measurement at least once in adulthood, which will make the discovery of elevated Lp(a) a more common finding in routine practice. Despite this, Lp(a) remains absent from conventional risk equations. Additional stratification tools including assessment of subclinical atherosclerosis can be further applied to help distinguish inherited susceptibility from expressed disease. All of this together should support a more informed shared decision regarding the intensity of preventive therapy in these cases. Summary We aim to provide a flexible framework that integrates Lp(a), contemporary risk equations, imaging, and selective genetics to produce actionable risk phenotypes which can guide the intensity of preventive decisions today.
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Steuerwald et al. (2026) conducted a review in Elevated lipoprotein(a) [Lp(a)] and atherosclerotic cardiovascular disease (ASCVD) risk. Multi-modal risk stratification integrating Lp(a), contemporary risk equations, imaging, and selective genetics was evaluated.
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