Table III.
Intervention strategies as a function of total cardiovascular risk and untreated Lp(a) concentration. This table is for reference purposes only, showing that at high Lp(a) values, the risk of a cardiovascular event is significantly underestimated. It also shows that modification of risk factors, such as elevated LDL-C and/or blood pressure, can reduce a person’s overall risk, even if the risk attributable to Lp(a) remains unchanged. To assess the risk associated with elevated Lp(a) and the effects of interventions that reduce Lp(a) and other risk factors, use the calculator available at: http://www.lpaclinicalguidance.com
| Total CV risk excluding Lp(a) (Pol-SCORE) %. | Lp(a) concentration | ||||||
|---|---|---|---|---|---|---|---|
| < 10 mg/dl (< 25 nmol/l) |
10–30 mg/dl (25–75 nmol/l) |
20–50 mg/dl (75–125 nmol/l) |
50–75 mg/dl (125–188 nmol/l) |
75–100 mg/dl (188-250 nmol/l) |
≥ 100 mg/dl (≥ 250 nmol/l) |
||
| Primary prevention | < 1, low risk | Lifestyle changes | Lifestyle changes | Lifestyle changes | Lifestyle changes | Lifestyle changes, pharmacological treatment should be considered* | Lifestyle changes along with concurrent pharmacotherapy |
| ≥ 1 to < 5 or risk moderate | Lifestyle changes | Lifestyle changes | Lifestyle changes | Lifestyle changes, pharmacological treatment should be considered | Lifestyle changes, pharmacological treatment should be considered | Lifestyle changes along with concurrent pharmacotherapy | |
| ≥ 5 to < 10 or risk large | Lifestyle changes | Lifestyle changes | Lifestyle changes, pharmacological treatment should be considered | Lifestyle changes along with concurrent pharmacotherapy | Lifestyle changes along with concurrent pharmacotherapy | Lifestyle changes along with concurrent pharmacotherapy | |
| ≥ 10 or risk very large | Lifestyle changes | Lifestyle changes, pharmacological treatment should be considered | Lifestyle changes along with concurrent pharmacotherapy | Lifestyle changes along with concurrent pharmacotherapy | Lifestyle changes along with concurrent pharmacotherapy | Lifestyle changes along with concurrent pharmacotherapy | |
| Secondary prevention | Very high risk | Lifestyle changes, pharmacological treatment should be considered | Lifestyle changes along with concurrent pharmacotherapy | Lifestyle changes along with concurrent pharmacotherapy | Lifestyle changes along with concurrent pharmacotherapy | Lifestyle changes along with concurrent pharmacotherapy | Lifestyle changes along with concurrent pharmacotherapy |
Pharmacotherapy refers to the optimal treatment of risk factors, related to LDL cholesterol levels, blood pressure, glucose levels. Prepared on the basis of [100].