Steve Nissen, MD: Optimizing Lp(a) Management by Learning from Missteps with LDL-C

In medicine, achieving optimal testing rates for diseases or biomarkers when providers are without approved or effective therapies is a problem without an obvious solution for major organizations and institutions across specialties.

For cardiology, among the most present examples of this discordance can be seen in regard to lipoprotein(a) [Lp(a)]—as evidence elucidating its association with elevated cardiovascular risk has emerged, many, such as the National Lipid Association, have pushed for greater uptake of testing, but data suggests rates still lag behind target goals, particularly among historically underserved populations.

In March 2024, the NLA released an update to its 2019 Scientific Statement on Use of Lipoprotein(a) in Clinical Practice calling for all adult patients to undergo Lp(a) testing at least once in their lives. According to NLA’s release announcing the update, this, and other updates to the statement, come as the result of new and emerging evidence.

At the Family Heart Foundation’s 2024 Family Heart Global Summit, Steve Nissen, MD, chief academic officer of the Heart, Vascular & Thoracic Institute at the Cleveland Clinic, used his keynote lecture to draw attention to how the lessons learned by the lipid community could help inform next steps as the same community nears highlight anticipated phase 3 readouts for Lp(a)-lowering agents such as pelacarsen, olpasiran, lepodisiran, and zerlasiran.

Nissen’s lecture, which was titled “From LDL-C to Lp(a): Those That Fail to Learn from History Are Doomed to Repeat It”, highlighted how cardiology needs to heed the warnings of past missteps, including addressing misinformation related to statin therapy and the high pricing of PCSK9 inhibitors upon release.

For more on the topic, check out our interview with Nissen from our time on-site at the 2024 Family Heart Global Summit.

Relevant disclosures for Nissen include Novartis and Eli Lilly and Company.

References:

1. Nissen S. From LDL-C to Lp(a): Those who Fail to Learn From History are Doomed to Repeat it. Presented at: 2024 Family Heart Global Summit. Dallas, TX. September 22-24, 2024.
2. National Lipid Association. National Lipid Association Releases Official Scientific Statement on a Focused Update to the 2019 Scientific Statement on Use of Lipoprotein(a) in Clinical Practice . National Lipid Association. April 1, 2024. Accessed October 1, 2024. https://www.lipid.org/sites/default/files/files/Lpa_in_Clinical_Practice_PR.pdf.