7
Table 4. ASCVD Risk Related to Lp(a) Concentrations*
Lp(a) Concentration
nmol/L
(mg/dL)
ASCVD Relative Risk:
Increase Compared With Population Median
(20 nmol/L, 7 mg/dL)
430 nmol/L
(180 mg/dL)
4-fold
350 nmol/L
(150 mg/dL)
3-fold
250 nmol/L
(100 mg/dL)
2-fold
125 nmol/L
(50 mg/dL)
1.4-fold
75–124 nmol/L
(30–49 mg/dL)
1.2-fold
<75 nmol/L
(<30 mg/dL)
Reference
* Lp(a) concentrations in this threshold range may be considered for repeat testing.
Data in the table are derived from the UK Biobank Study, are intended as a general guide
and may differ in other populations. For example, relative risk of 2-fold has been observed for
levels of 200 nmol/L in some populations. Equivalence of levels between nmol/L and mg/
dL is approximate. An Lp(a) level of 50 mg/dL (125 nmol/L, ~80th percentile) is associated
with an ~40% relative risk increase in ASCVD compared with 7 mg/dL (20 nmol/L, median
in a reference population). An Lp(a) level of 100 mg/dL (≥250 nmol/L, ~95th percentile)
approximately doubles the ASCVD risk. An Lp(a) level of 180 mg/dL (≥430 nmol/L, ~99th
percentile) increases the ASCVD risk by ~4-fold, similar to the risk of heterozygous familial
hypercholesterolemia.
ASCVD indicates atherosclerotic cardiovascular disease; and Lp(a), lipoprotein (a).
3.5. Monitoring and Follow-Up
COR LOE
Recommendation
1 A
1. In individuals on LLT, clinicians should perform a lipid
profile 4 to 12 weeks after initiation or dose adjustment
and every 6 to 12 months thereafter to assess efficacy and
adherence to LLTs.
