Lipoprotein(a) as a Cardiovascular Risk Factor: Current Status — EAS Consensus

This is the document that put lipoprotein(a) on the clinical map. Before 2010, Lp(a) was a known oddity of lipid biology; this European Atherosclerosis Society consensus was the first major statement to argue it should change what doctors do.

Its contribution was to issue the first concrete recommendations: whom to screen — patients at intermediate or high cardiovascular risk, those with premature disease or a strong family history — what level should be considered desirable, and what could be done about an elevated result. In an era before targeted drugs existed, the therapeutic options it could point to were limited, and it leaned on niacin as the available agent for lowering Lp(a).

The reason it still matters is lineage. Nearly every Lp(a) document that followed — the 2022 EAS update, the AHA and NLA statements — builds on the foundation this panel laid. It established the framing, the screening logic, and the desirable-level concept that the field has refined ever since.

The honest limitations are the ones time imposed. Its therapeutic advice is dated: niacin later failed to show outcome benefit and fell out of favor, and the precise measurement standards and risk thresholds have since been substantially sharpened.

We rate the evidence strong as a foundational consensus. Read today, it is best understood as the origin point of clinical Lp(a) testing — the statement that first insisted this inherited, invisible risk factor deserved a place in routine cardiovascular assessment.