Article Details

Lipoprotein(a) [Lp(a)] is genetically determined lipoprotein which independently contributes to atherosclerotic cardiovascular disease (ASCVD) and calcific aortic valve disease [1,2]. Despite its recognised causal role, Lp(a) measurement remains underutilised in routine practice. We present a woman (49 years old) with strong family history of premature coronary artery disease (PCAD) who was found to have a markedly elevated Lp(a) concentration of 753 nmol/L. Her LDL‑cholesterol improved from 5.8 to 2.6mmol/L with high‑intensity statin therapy, yet her persistently elevated Lp(a) placed her at very high lifetime cardiovascular risk. Comprehensive laboratory evaluation revealed pre‑diabetes, normal renal and liver function, and no evidence of systemic inflammation. This case emphasises the importance of targeted Lp(a) testing, early risk stratification, and aggressive LDL‑cholesterol reduction in individuals with inherited cardiovascular risk factors. Emerging Lp(a)‑lowering therapies may further transform management in this high‑risk population.