Study: Very high lipoprotein(a) levels tied to higher risk of stroke and cardiovascular death

A new analysis suggests that very high levels of lipoprotein(a), or Lp(a), are associated with a higher risk of major cardiovascular events—particularly stroke and cardiovascular death—especially among people who already have cardiovascular disease.

The study did not find a clear association between elevated Lp(a) and heart attack risk in this analysis. Researchers say the results support Lp(a) as an important genetic risk factor that may help refine cardiovascular risk assessment, particularly when risk remains elevated despite standard treatment.

What the analysis found According to the report, people with Lp(a) levels of 175 nmol/L or higher had a significantly higher risk of stroke and cardiovascular death. The association was strongest among individuals with pre-existing cardiovascular disease, pointing to Lp(a) as a potential contributor to “residual” risk—ongoing risk even when other factors, such as LDL cholesterol, are being treated.

Why Lp(a) is often overlooked Lp(a) is a cholesterol-carrying particle in the blood that is largely determined by genetics and is not significantly influenced by diet or exercise. Despite estimates that roughly 20% of people have elevated Lp(a), testing is not routinely performed.

The analysis highlighted 175 nmol/L as a threshold linked to substantially increased risk. Researchers suggest that identifying patients with very high Lp(a) could support more aggressive management of other cardiovascular risk factors and inform future treatment strategies.