Table 1.

Societal recommendations for lipoprotein (a) population screening

Society	Currently applicable screening guidelines
2018 ACC/AHA Cholesterol Guidelines [47••]	– No specific screening recommendation however; elevated Lp(a) (≥50 mg/dL or 125 nmol/L) is noted as a “risk enhancing” factor if measured – Presence of risk enhancing factors favor statin therapy use in those 40–75-year-old adults, without diabetes mellitus, with 10-year ASCVD risk of >5–19.9%
2019 NLA Scientific Statement [48]	– Lp(a) screening reasonable or “may be” reasonable among:   Personal or first-degree family history of premature ASCVD   Recurrent or progressive ASCVD despite optimal lipid therapy   Family history of elevated Lp(a)   Primary severe hypercholesterolemia or suspected familial hypercholesterolemia   Intermediate risk patients ( >5–19.9% ACC/AHA 10-year ASCVD risk)   Very high risk of ASCVD (to define PCSK9 inhibitor benefit)   Statin resistance   Progressive aortic stenosis
2019 ESC/EAS Dyslipidemia Guidelines [49••]	– Measure Lp(a) at least once in each adult’s lifetime to identify those with very high inherited Lp(a) levels >180 mg/dL (>430 nmol/L) – Consider Lp(a) measurement in selected patients with: Family history of premature coronary artery disease or elevated Lp(a) For reclassification of risk in those are at borderline between moderate to high risk of CVD
HEART UK Consensus Statement [43]	– Personal of family history of premature ASCVD –First degree relative with elevated Lp(a) levels (>200 nmol/L) – Calcified aortic valve stenosis – Borderline increased 10-year risk of ASCVD events* for risk reclassification
2016 Canadian Cardiovascular Society Guidelines [50]	– Individuals within intermediate Framingham Risk category (10–19%) – Family history of premature ASCVD

*Lp(a) best re-classifies cardiovascular disease risk in people at intermediate risk calculated by the ACC/AHA 10-year ASCVD risk <15%; >15% risk recommended to be on statin therapy regardless of Lp(a) levels

Abbreviations: ACC/AHA; American College of Cardiology/American Heart Association, ESC; European Society of Cardiology EAS; European Atherosclerosis Society.