Lp(a): The underestimated risk factor before the turning point

One in five people worldwide has a genetically elevated lipoprotein(a) – and knows nothing about it. Unlike LDL cholesterol, this independent, causally significant risk factor cannot be significantly influenced by diet, exercise or statins. This therapeutic gap has existed for decades. Now we are close to the turning point: RNA-based drugs reduce Lp(a) by up to 95%, and the first cardiac outcomes study, Lp(a)HORIZON, expects its results in the first half of 2026. The Focused Update of the ESC/EAS dyslipidemia guidelines published in 2025 anchors Lp(a) as a mandatory screening target for all adults for the first time.