Does Lipoprotein(a) Play a Causal Role in Atherosclerotic Cardiovascular Disease?

Michelle L. O'Donoghue, MD, MPH; Stephen J. Nicholls, MBBS, PhD

November 28, 2022

This transcript has been edited for clarity.

Michelle L. O'Donoghue, MD, MPH: Hi. I'm Dr Michelle O'Donoghue. I'm a cardiologist at Brigham and Women's Hospital, and I'm reporting for Medscape. Joining me today is Dr Stephen Nicholls. He's a professor of cardiology at Monash University in Australia. Welcome.

Stephen J. Nicholls, MBBS, PhD: Thanks.

O'Donoghue: He's really a world expert on the field, in general, of lipid therapies, but one evolving area that we're learning more and more about is this concept of lipoprotein(a) [Lp(a)] and the role it may play in heart disease.

Let's start there and think about the evidence that we have in terms of Lp(a) and its potential role in heart disease and cardiovascular disease more broadly.

Nicholls: We've known about Lp(a) since the early 60s. If you think about it, when most of us did our training, Lp(a) was one of those quirky risk factors that you'd occasionally measure when somebody had a myocardial infarction (MI) and you couldn't understand why. In recent years, we understand more about the biology and the genetics of Lp(a).

Large population studies have shown us that high Lp(a) is not only associates with a high rate of atherosclerotic cardiovascular disease

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