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Pablo Corral: Association of Lp(a) With Coronary Atherosclerosis and CV Events
Pablo Corral/LinkedIn
Oct 6, 2026, 02:18

Pablo Corral: Association of Lp(a) With Coronary Atherosclerosis and CV Events

Pablo Corral, Pharmacology Professor at FASTA University, Past President of Argentine Lipid Society, shared a post on LinkedIn about a recent article by Elias Björnson et al., published in  JACC: Cardiovascular Imaging, adding:

“Association of Lp(a) With Coronary Atherosclerosis and CV Events

Lp(a): perhaps more atherogenic than thrombogenic?

1. What does SCAPIS cohort tell us?

In gt;28,000 individuals followed for 7.8 years, high Lp(a) was associated with:

  • More coronary atherosclerosis
  • Earlier development of plaque
  • More obstructive disease
  • Approximatelly 50% higher risk of coronary events

But here is the key: At a similar plaque burden, high Lp(a) was NOT associated with more events. Mediation analysis suggested that most of the excess risk associated with Lp(a) was explained by greater atherosclerotic burden, with no significant direct effect on events.

2.Could this help us think about the negative Lp(a)HORIZON trial?

Perhaps.

If the major clinical effect of Lp(a) is to accelerate atherosclerosis over decades, rather than primarily triggering thrombosis on established plaques, then: Lowering Lp(a) late in the disease course may not rapidly reverse decades of accumulated plaque burden.

This does not rule out prothrombotic or plaque-vulnerability effects.

But it raises an important question after HORIZON: With Lp(a), could timing matter as much as lowering?”

Title: Association of Lipoprotein(a) With Coronary Atherosclerosis and Cardiovascular Events: Findings From the SCAPIS Cohort

Authors: Elias Björnson, Göran Bergström, Jonas Brinck, David Erlinge, Carl Johan Östgren, Stefan Söderberg, Tomas Jernberg, Jan Borén, Emil Hagström

Pablo Corral: Association of Lp(a) With Coronary Atherosclerosis and CV Events

Other featuring Pablo Corral on Hemostasis Today.

Atherosclerosis Carl Johan Östgren CV David Erlinge Elias Björnson Emil Hagström Göran Bergström Health Hematology Hemostasis Hemostasis News Hemostasis Today Jan Borén Jonas Brinck Lp(a) Medicine Pablo Corral Stefan Söderberg Tomas Jernberg
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