9 In Whom Should Lp(a) Be Measured? z Family history of premature CVD (men, age <55 years; women, age <65 years). z A personal history of premature CVD. z Individuals with Familial Hypercholesterolemia. z Individuals with family history of elevated Lp(a). Because the majority of Lp(a) plasma concentration (up to 90%) is influenced by genetics through the LPA gene5, relative indications for its measurements are: Lp(a) should be measured at least once in adulthood to identify individuals at increased ASCVD risk. An Lp(a) level ≥125 nmol/L (≥50 mg/dL) is considered a risk-enhancing factor, which is associated with about a 1.4-fold increased ASCVD risk, and values ≥250 nmol/L (100 mg/dL) are associated with ≥2-fold higher estimated risk. Elevated Lp(a) should prompt more intensive management of LDL-C and other modifiable cardiovascular risk factors. Cascade measurement in first-degree relatives of individuals with elevated Lp(a) is recommended. However, despite recent guidelines suggesting measurement of Lp(a) in all adults, the testing rate for Lp(a) remains very low.4,26 If a decision is made to measure Lp(a), an Lp(a) ≥125 nmol/L (≥50 mg/dL) may be considered a risk-enhancing factor for CVD events.4 Lp(a): A Toolkit for Healthcare Professionals
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