Cardiovascular prevention is expanding beyond the standard lipid panel. For World Heart Day, updated guidance and emerging research on lipoprotein(a) [Lp(a)] bring a practical question into focus: how can identifying inherited risk change prevention decisions?
Updated guidance: a broader view of cardiovascular risk
The 2026 ACC/AHA multisociety dyslipidemia guideline recommends measuring Lp(a) at least once in adulthood. It also introduces PREVENT-ASCVD risk estimation and restores risk-based LDL-C and non–HDL-C treatment goals, reinforcing a more individualized approach to prevention.¹
For patients with elevated Lp(a), the clinical relevance extends beyond identifying another abnormal laboratory value. The guideline supports more intensive LDL-C lowering and management of other cardiovascular risk factors—connecting recognition of inherited risk with actions available today.¹
Emerging research: targeting Lp(a) itself
RNA-based approaches are also advancing. A 2025 phase 2 randomized trial involving 320 participants found substantial, sustained Lp(a) reductions with an investigational small interfering RNA targeting hepatic apolipoprotein(a) production. Generally mild injection-site reactions occurred; serious adverse events were reported but were not considered treatment-related by investigators. The study established biomarker lowering, not a reduction in cardiovascular events.²
What LinQ adds: a year-over-year real-world signal
Against this evolving clinical backdrop, an analysis using NorstellaLinQ Real-World Data Explorer examined patients with at least one selected structured Lp(a) result in 2024 and 2025. Patient counts increased across three laboratory sources:
| Laboratory source | Increase in patients with a recorded Lp(a) result, 2024–2025 |
|---|---|
| Source A | 47.3% |
| Source B | 62.8% |
| Source C | 65.3% |
A similar upward trend was reported in a US electronic health record study published in 2025, which found an increase in patients tested annually for Lp(a) between 2015 and 2024.³
These findings show growth in recorded Lp(a) results before the 2026 guideline. They do not establish testing rates, the clinical reason for assessment, or changes in management; source coverage and data capture may also contribute.
Together, the developments raise a practical issue for cardiovascular care: how to translate an elevated Lp(a) result into a personalized prevention plan.
Join the discussion
- How are you incorporating once-in-adulthood Lp(a) measurement into your workflow, and what would make implementation easier?
- When Lp(a) is elevated but LDL-C is already at the patient’s current goal, what most influences your next step in risk assessment or prevention?
LinQ source: NorstellaLinQ Real-World Data Explorer. Adults aged ≥18 years with at least one selected structured Lp(a) result reported in mg/dL or nmol/L during calendar years 2024 and 2025. Percentages represent year-over-year changes in patient counts within each laboratory source, analyzed separately; they are not testing rates. Analysis conducted September 2026. Findings may be affected by source coverage, data availability, linkage, and result mapping. Testing indication, ordering specialty, and first-time versus repeat testing were not assessed.
