Lipoprotein(a): a Case for Universal Screening in Youth

Assessment of Apolipoprotein(a) Isoform Size Using Phenotypic and Genotypic Methods

“…Of course, an advanced investigation of the Lp(a) isoforms and genetics make sense, whereas CVD prevention is a national public health priority, quantitative Lp(a) screening is already widely available, and the access to second-level lipid-lowering treatments exists and is supported by the public health system and/or insurances. In the United States, for instance, universal Lp(a) screening in the youth has been estimated to be feasible and cost-effective [ 89 ]. In these circumstances, the simultaneous application of methods for both the phenotyping and genotyping aspects [ 46 ] in association with the CV risk—especially for the most studied techniques including Western blotting with SDS agarose [ 90 , 91 ] and qPCR [ 29 , 92 , 93 , 94 ]—provide more complete information for the personalized management of individuals with an increased CV risk.…”

Lipoprotein (a) and cerebrovascular disease

“… 42 Some authors recommend that routine Lp(a) screening should be offered to pre-adolescents and young adults, as this would determine those at high risk for ASCVD with the intent of early intervention, if required. 43 According to a special scientific statement by the American Heart Association Stroke Council and the Council on Cardiovascular Disease in the Young, Lp(a) level screening is not warranted, although elevated Lp(a) is recognized as a risk factor for hypercoagulability. 44 Nevertheless, in youth found to have elevated Lp(a) levels, it is important to emphasize early and lifelong adoption of a heart-healthy lifestyle, especially with respect to smoking avoidance or cessation, given the thrombotic risk attributable to Lp(a).…”