Lipoprotein(a) Testing in Children

Primary Screening Recommendations

• The American College of Cardiology recommends measuring Lp(a) as early as age 2 years in children with a family history of either early cardiovascular disease or significant hypercholesterolemia 3, 4, 5
• The American College of Cardiology suggests repeating Lp(a) testing at puberty (≥12 years) even if previous values were normal 2

Clinical Thresholds and Actions

• Markedly elevated Lp(a) (>75 nmol/L) combined with elevated LDL-C increases the risk of myocardial infarction 10-fold or higher, according to the American College of Cardiology 1
• The American College of Cardiology recommends intensifying LDL-C reduction goals to approximately 50% from baseline, with a target of <100 mg/dL when Lp(a) is elevated 1
• The American College of Cardiology suggests considering statin therapy at age ≥10 years if LDL-C remains ≥160 mg/dL after lifestyle modification, particularly with elevated Lp(a) 1
• The American College of Cardiology recommends performing cascade screening of first-, second-, and third-degree biological relatives when Lp(a) is elevated 3, 4, 5, 2