Lipoprotein(a): An Underappreciated Inherited Risk Factor for Atherosclerosis, Aortic Stenosis, and Abdominal Aortic Aneurysm.

Koschinsky, Marlys L; Kalra, Dinesh K; Boffa, Michael B · Annu Rev Med · 2026

review · Level V

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Abstract

Elevated plasma concentration of lipoprotein(a) is a highly prevalent, independent, and causal risk factor for the development of numerous cardiovascular diseases. This review summarizes the key clinical evidence for elevated lipoprotein(a) as a risk factor for atherosclerotic cardiovascular disease, aortic stenosis, and abdominal aortic aneurysm. These data are specifically linked to ongoing developments in understanding the pathophysiological mechanisms of lipoprotein(a) in these contexts. Highly potent lipoprotein(a)-lowering therapies are being studied in cardiovascular outcomes trials for their ability to prevent major adverse coronary events and aortic stenosis progression, potentially ushering in a new era of clinical management of lipoprotein(a).

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