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Study supports treatment of lipoprotein(a) to reduce heart risks: JACC

CardioSmart Jan 10, 2020

Treating high levels of a unique protein in the blood could reduce risk for heart disease, based on a genetic study of more than 143,000 adults from Iceland. The study explored the role of lipoprotein(a), which has been linked to increased risk for heart disease and suggests that patients with very high levels of the protein could benefit from treatment.


Published in the Journal of the American College of Cardiology, this study analyzed genetic data from 143,087 Icelandic adults. The goal was to see how lipoprotein(a) impacts heart risks and whether lowering levels could improve outcomes. The study also looked at whether low levels of the protein are linked to diabetes, as previous research suggests, which could complicate potential therapy.

Lipoprotein(a) is a type of protein in the blood that has been linked to heart risks, even in patients with normal cholesterol levels.

What analysis showed is that very high levels of lipoprotein(a) are associated with increased risk for heart disease. The study also linked high protein levels to heart failure, peripheral artery disease, aortic valve stenosis, and even a shortened lifespan.

The good news, according to authors, is that treating high levels of lipoprotein(a) could reduce that risk.

As expected, the study found that patients with very low levels of lipoprotein(a) had increased risk for type 2 diabetes, which is a known risk factor for heart disease. However, projections show that treating patients with the highest levels of lipoprotein(a) would not put them in danger of developing type 2 diabetes.

Findings are promising, since lipoprotein(a) could offer an additional way to identify and treat patients at risk for heart disease. The challenge, however, is that we don’t currently have all the tools needed to treat the condition.

Researchers are working to develop therapies but as it stands, there are no FDA-approved treatments proven to raise or lower lipoprotein(a). Experts also note that lipoprotein(a) is mainly genetic and does not change much with lifestyle changes like diet and exercise.

The next step, according to authors, is to identify ways to control lipoprotein(a) to help prevent heart disease, as well as type 2 diabetes. In the meantime, it’s important that anyone with risk factors for heart disease—including high lipoprotein(a) levels—take steps to help reduce their cardiovascular risk.

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