All articles tagged with #lpa
Novartis said pelacarsen lowered lipoprotein(a) but did not reduce the rate of heart attacks, strokes or other major cardiovascular events in the Phase 3 Lp(a)Horizon trial involving 8,323 high-risk patients; full topline results will be presented at a medical meeting, and analysts note deeper Lp(a) suppression or subpopulation effects might still matter for future efforts in this space.
Novartis said pelacarsen, an experimental Lp(a)-lowering drug, failed to reduce cardiovascular death or events in the Phase 3 HORIZON trial, marking a major setback for the Lp(a) program and complicating rival efforts from Amgen and Eli Lilly.
Novartis announced that pelacarsen, an experimental drug designed to lower lipoprotein(a) and reduce risk of heart attack, stroke, and cardiovascular death, failed in a large clinical trial, delivering a shock to the field of cardiology and ending hopes for a new era in heart-disease prevention.
Rival drugmakers, led by Novartis, are sprinting to prove that lowering Lp(a) — a genetic risk factor affecting about 1 in 5 people — can prevent heart disease, a space with no approved therapies and a potential multi‑billion market as late-stage trials seek to show fewer cardiovascular events.
Heart attack risk isn’t determined by cholesterol alone. Doctors emphasize the broader metabolic picture—blood pressure, blood sugar, abdominal obesity, physical activity, sleep, and family history—to assess risk. Some important markers not in routine lipid tests, like lipoprotein(a) and ApoB, can provide a clearer view of atherogenic risk, and coronary artery calcium scoring via CT can reveal existing plaque in selected individuals. Even with normal cholesterol, symptoms such as chest discomfort or breathlessness should be evaluated. The goal is to identify the right risk factors for each person and intervene early, recognizing that heart health is a mix of factors rather than a single number.
Updated guidelines emphasize that the duration of LDL exposure and overall cardiovascular risk drive prevention, prompting earlier statin use and personalized LDL targets (below 55 mg/dL for very high risk, 70 mg/dL for high risk, up to 100 mg/dL for intermediate). The PREVENT calculator informs treatment intensity, and Lp(a) testing is now recommended once in adulthood. Start cholesterol screening in ages 9–11 and repeat every five years from 19. Statins are generally safe; muscle-related side effects are rare, and if one statin isn’t tolerated, another can often be tried.
The 2026 ACC/AHA Dyslipidemia Guideline updates risk assessment with a new PREVENT calculator, reintroduces explicit LDL-C targets (including very low goals for high-risk individuals), and adds universal lipoprotein(a) screening and calcium scoring for intermediate risk. About 1 in 3 Americans without heart disease have LDL above the new goals, and nearly 4 in 5 with a prior cardiovascular event do. Treatment is now driven by overall cardiovascular risk rather than a single LDL number, with options spanning statins to non-statin therapies (ezetimibe, PCSK9 inhibitors, Inclisiran) and the new Lipfrenda, while supplements generally don’t replace proven therapies. The guidelines also flag undertreatment and racial disparities in statin use and emphasize early, personalized risk-based decisions.
A new JAMA study finds measuring apolipoprotein B (apoB) in cholesterol screening may more accurately identify who needs treatment to prevent heart attacks and strokes than LDL or non-HDL cholesterol. The findings align with updated guidelines that emphasize additional tests, like Lp(a), for assessing risk, and suggest apoB can reveal cardiovascular risk even when LDL appears normal.
The ACC/AHA's updated cholesterol guidelines urge starting prevention early, expand testing beyond traditional cholesterol (including Lp(a) and ApoB) and use risk tools like CAC scanning to tailor treatment. They emphasize lifestyle first—plant-based, whole foods, limited ultra-processed foods, regular exercise, stress management, and adequate sleep—with routine cholesterol checks for adults 19+ and childhood screening for those with family history. While lifestyle changes are central, medications such as statins may be necessary for some, and supplements are not a reliable shortcut. Prevention is a lifelong commitment.
Dr. Jennifer Roelands argues that standard wellness panels miss key midlife risks for women and recommends five essential tests: ApoB and Lp(a) for cardiovascular risk; fasting insulin for metabolic health; vitamin D and ferritin for nutrient status; a full thyroid panel (TSH, free T3/T4, antibodies); and free/total testosterone with SHBG to inform treatment decisions. These tests are not usually part of routine panels but enable proactive, precision care during perimenopause; bring this list to your next appointment or order the tests yourself if necessary.
The American College of Cardiology and the American Heart Association issued new cholesterol guidelines: start screening earlier, add a one-time Lp(a) test, use a smarter PREVENT risk calculator, lower LDL targets (below 100 for healthy, under 70 for medium risk, under 55 for high risk), and expand treatment options with newer meds alongside lifestyle changes. The piece also links health stewardship to Jewish law, outlining six mitzvot that emphasize protecting life and well-being and urging individual doctor-guided plans.
Updated ACC/AHA cholesterol guidelines emphasize earlier detection and personalized risk assessment, with more aggressive LDL-C lowering and a new PREVENT risk calculator for 10- and 30-year risk starting at age 30; recommend one-time Lp(a) testing, consider risk enhancers and coronary calcium scoring to tailor therapy, set LDL targets of <100 mg/dL for most, <70 mg/dL for intermediate risk, and <55 mg/dL for high risk, and expand therapies beyond statins (ezetimibe, bempedoic acid, PCSK9 inhibitors); childhood screening for familial hypercholesterolemia is advised, while lifestyle remains foundational.
Lp(a) is a genetically determined cholesterol particle linked to higher risk of heart attack and stroke that standard tests miss. Lifestyle and most cholesterol meds don’t meaningfully lower Lp(a); newer gene-silencing therapies show large reductions in Lp(a) in trials and could reduce events if confirmed. Testing is often advised for those with a family history or unexplained risk, but for now heart health still hinges on managing LDL cholesterol, blood pressure, smoking, activity, and diet.
Novartis, Amgen and Eli Lilly are racing to prove that lowering Lipoprotein(a) can prevent heart attacks. They’re in late-stage trials of pelacarsen, olpasiran and lepodisiran, which have achieved >80% reductions in Lp(a) so far, but it’s unclear if this lowers events; readouts are due mid-year for Novartis, 2027 for Amgen, and 2029 for Lilly. A successful outcome could unlock a multi-billion-dollar market—about $5.6 billion annually by 2032—though doctors say screening for Lp(a) remains uncommon and uptake will depend on solid outcome data.
Cardiologists say the only reliable way to know if cholesterol is too high is a blood test. High LDL and low HDL increase heart-disease risk, and new guidelines call for regular lipid screening—from childhood through adulthood (every five years) and measuring lipoprotein(a) at least once. Most people have no early symptoms, so routine testing plus healthy lifestyle choices (diet, exercise, no smoking) are key; signs like chest pain or shortness of breath usually appear only after disease has progressed.