Familial Hypercholesterolemia and Lipoprotein(a): Two Partners in Crime?

Curr Atheroscler Rep. 2022 Jun;24(6):427-434. doi: 10.1007/s11883-022-01019-5. Epub 2022 Apr 7.


Purpose of review: Familial hypercholesterolemia is a high cardiovascular risk disorder. We will review the role of lipoprotein(a) in cardiovascular risk and in aortic valve stenosis in familial hypercholesterolemia, as well as its association with their phenotype, and strategies to identify this high-risk population.

Recent findings: Patients with familial hypercholesterolemia have higher lipoprotein(a) levels mainly due to an increased frequency of LPA variants, and the cardiovascular risk is increased twofolds when both conditions coexist. Also, an increased risk for aortic valve stenosis and valve replacement has been observed with high lipoprotein(a) levels. Assessment of lipoprotein(a) during the cascade screening for familial hypercholesterolemia is a good opportunity to identify this high-risk population. High cardiovascular risk in familial hypercholesterolemia is increased even more when lipoprotein(a) is also elevated. Measurement of lipoprotein(a) in these patients is crucial to identify those subjects who need to intensify LDL-cholesterol reduction pending availability of lipoprotein(a)-specific treatments.

Keywords: Aortic valve stenosis; Atherosclerotic cardiovascular risk; Cascade screening; Familial hypercholesterolemia; Lipoprotein(a).

Publication types

  • Review

MeSH terms

  • Aortic Valve Stenosis* / complications
  • Cholesterol, LDL
  • Crime
  • Humans
  • Hyperlipoproteinemia Type II* / complications
  • Hyperlipoproteinemia Type II* / diagnosis
  • Hyperlipoproteinemia Type II* / genetics
  • Lipoprotein(a) / blood*


  • Cholesterol, LDL
  • LPA protein, human
  • Lipoprotein(a)