Coronary artery calcification (CAC) signifies advanced atherosclerosis and portends increased cardiovascular risk. Lipoprotein(a) Lp(a) is a causal risk factor for atherosclerosis; however, its association with in vivo lesion morphology and clinical outcomes in patients with symptomatic, advanced CAC remains incompletely characterized. This study aimed to investigate the association between elevated Lp(a) levels and both in vivo lesion morphology and clinical outcomes in this high-risk population. In this retrospective cohort, 292 patients with intravascular ultrasound(IVUS)-confirmed CAC were stratified into elevated (≥50mg/dL,n=77) or low (7-fold higher risk of ischemic stroke in this advanced CAC cohort. • In-stent restenosis risk is nearly tripled in patients with elevated Lp(a) and severe calcification. • Aortic valve calcification is over 4 times more prevalent in patients with elevated Lp(a).
Xiao et al. (2026) studied this question.