Lipoprotein(a) and subclinical atherosclerosis.

BACKGROUND: Lipoprotein(a) [Lp(a)] is a causal risk factor for atherosclerotic cardiovascular disease. SOURCES OF MATERIAL: Literature review. ABSTRACT OF FINDINGS: A large body of evidence has established the association between Lp(a) and subclinical atherosclerosis. In particular, Lp(a) is associated with coronary artery calcium (CAC), coronary artery plaque identified by coronary computed tomography angiography (CCTA), and carotid artery plaque. Lp(a) is more strongly associated with noncalcified coronary artery plaque than calcified plaque. In addition, CAC scoring has demonstrated utility for risk stratification among individuals with elevated Lp(a). The role of CCTA and carotid imaging to risk-stratify individuals with elevated Lp(a) in a primary prevention setting remains to be established. CONCLUSIONS: Lp(a) is associated with subclinical atherosclerosis, and imaging for subclinical atherosclerosis is useful for risk-stratifying individuals with elevated Lp(a).