• Maria G Matta, Laura Schreier, Augusto Lavalle-Cobo, Sebastian Garcia-Zamora, Agustina Ferraresi, Angeles Madsen, Sofia Bellini, Guadalupe Ramos, Paula Roubicek, and Pablo Corral.
• Department of Pharmacology, Faculty of Medicine, Universidad FASTA, Clinical Researcher at the Clinical Research Institute (IIC), Mar del Plata, Argentina; Cardiology Department, Townsville University Hospital, 100 Angus Smith Dr, Douglas QLD 4814, Australia. Electronic address: magabrielama@gmail.com.
• Med Clin (Barc). 2024 Nov 15; 163 (9): 436441436-441.

ObjectivesLipoprotein(a) [Lp(a)] is a significant risk factor for cardiovascular disease, yet it is often overlooked in routine clinical assessments. As a primarily genetically determined risk factor, the traditional recommendation is to assess its level once in a lifetime, as the variability of Lp(a) over time is considered to be minimal. This study aims to evaluate the potential variability of Lp(a) in clinically stable patients and investigate factors contributing to the lack of stable levels.MethodsA retrospective analysis was conducted on a sample of adult patients attending a lipid clinic. Participants with at least two Lp(a) measurements taken with a minimum interval of four months were included. Lp(a) measurements were performed using the immunoturbidimetric assay. Variability in Lp(a) values was calculated as a percentage change from baseline, with participants exceeding a 25% change classified as having hypervariable Lp(a) levels. Additional clinical and biochemical variables were assessed.Results61 participants with 171 Lp(a) determinations were included. Thirty-four percent exhibited a variability of 25% or higher (hypervariable). Men showed slightly greater variability than women. Changes in Lp(a) categories were observed among hypervariable patients, with some participants experiencing an increase while others showed a decrease. Menopause was present in all the women with hypervariable levels.ConclusionOur study suggests reconsidering the reliance on a single Lp(a) measurement for assessing cardiovascular risk. Repeat measurements, particularly in borderline cases, may be beneficial.Copyright © 2024 Elsevier España, S.L.U. All rights reserved.

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