With the 2026 guideline recommending once-in-a-lifetime Lp(a) measurement for all primary and secondary prevention patients — but no approved Lp(a)-lowering therapy and outcome trials (e.g., Lp(a) HORIZON) still unread — should health systems implement universal Lp(a) screening now, or restrict testing to targeted populations (family history of premature ASCVD, FH, recurrent events despite LDL control) until a therapy proves measuring it changes hard outcomes rather than just intensifying statin/PCSK9 therapy we'd often give anyway?
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With the 2026 guideline recommending once-in-a-lifetime Lp(a) measurement for all primary and secondary prevention patients — but no approved Lp(a)-lowering therapy and outcome trials (e.g., Lp(a) HORIZON) still unread — should health systems implement universal Lp(a) screening now, or restrict testing to targeted populations (family history of premature ASCVD, FH, recurrent events despite LDL control) until a therapy proves measuring it changes hard outcomes rather than just intensifying statin/PCSK9 therapy we'd often give anyway? | Synapse Debates