Clinical Resources

Lp(a)-Adjusted ASCVD Risk

Lipoprotein(a)-Enhanced Cardiovascular Risk Assessment

Adjusts baseline ASCVD risk estimate for elevated lipoprotein(a) levels. Lp(a) is an independent, genetically determined causal risk factor for ASCVD. Recommended as a one-time measurement per 2018 AHA/ACC cholesterol guidelines.

Enter 10-year risk from PCE or PREVENT calculation
Approximate conversion: 1 mg/dL ≈ 2.5 nmol/L (varies by assay)

Lp(a) Thresholds

  • < 75 nmol/L (30 mg/dL): Normal — no significant additional risk.
  • 75–125 nmol/L (30–50 mg/dL): Moderately elevated — ~1.3× risk multiplier. Consider as risk enhancer.
  • 125–250 nmol/L (50–100 mg/dL): High — ~1.5–1.8× risk. Recognized risk enhancer per ACC/AHA guidelines.
  • > 250 nmol/L (>100 mg/dL): Very high — ~2.0× risk. Comparable to heterozygous FH in lifetime risk.

References

Grundy SM et al. (2019) — 2018 AHA/ACC Cholesterol Clinical Practice Guidelines. JACC. 73(24):e285–e350.

Emerging Risk Factors Collaboration (2009) — Lp(a) and risk of coronary heart disease. Lancet. 375:1536–44.