The Brussels International Declaration on Lipoprotein(a) Testing and Management
- PMID: 40340180
- DOI: 10.1016/j.atherosclerosis.2025.119218
The Brussels International Declaration on Lipoprotein(a) Testing and Management
Abstract
There is striking evidence that a high lipoprotein(a) [Lp(a)] concentration is a strong, independent, and causal cardiovascular risk factor. However, Lp(a) testing rates are very low (1 %-2 %) despite the fact that 1 in 5 individuals have elevated Lp(a) concentrations. The Brussels International Declaration on Lp(a) Testing and Management was co-created by the Lp(a) International Task Force and global leaders at the Lp(a) Global Summit, held in Brussels, Belgium, on March 24-25, 2025. The event, organized by FH Europe Foundation, brought together scientific experts, people with the lived experience of elevated Lp(a) and policy makers from the European Institutions and World Health Organization. The World Heart Federation, Global Heart Hub, and European Alliance for Cardiovascular Health and scientific organizations such as European Atherosclerosis Society, and International Atherosclerosis Society were formal partners. The Summit was hosted by a Member of the European Parliament, Romana Jerković, and held under the patronage of the Polish presidency of the Council of the European Union. The Declaration calls for 1) integration of Lp(a) testing and management into Global, European and National Cardiovascular Health Plans; 2) appropriate investment, policy and programmes in targeting Lp(a) testing and management based on a recent study demonstrating the substantial overall cost-saving to health systems across the globe; 3) political commitment to mandate systematic Lp(a) testing at least once during a person's lifetime, ideally at an early age, with full reimbursement; 4) incorporation of Lp(a) test results in the context of a person's cardiovascular risk assessment, with development of personalised cardiovascular health roadmaps as needed, without fear of dredit aiscrimination; 5) investment in public and healthcare professional education to increase awareness of Lp(a) and its impact on cardiovascular health.
Keywords: Cardiovascular risk; Cardiovascular risk evaluation; Lipoprotein(a); Patient engagement; Screening.
Copyright © 2025 The Authors. Published by Elsevier B.V. All rights reserved.
Conflict of interest statement
Declaration of competing interest The author is Deputy Editor-in-Chief for this journal and was not involved in the editorial review or the decision to publish this article. The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Florian Kronenberg: consulting and/or lecture fees from Novartis, Amgen, Silence Therapeutics, and Roche; Nicola Bedlington: consulting fees from EFPIA, Galapagos, GSK, Nestle Science, Novartis, Recordati, Roche, Sobi, the Synergist UCB; Mariko Harada-Shiba: consulting and/or lecture fees from Amgen, Novartis and Silence Therapeutics; George Thanassoulis: lecture and/or consultant fees from Amgen, Sanofi, Novartis, HLS therapeutics, Silence, New Amsterdam and Novo Nordisk; Christie M. Ballantyne: grant/research support (through his institution) from Abbott Diagnostic, Akcea, Amgen, Arrowhead, Ionis, Eli Lilly, Merck, New Amsterdam, Novartis, Novo Nordisk, and Roche Diagnostic for contracted research and consulting fees from 89Bio, Abbott Diagnostics, Amgen, Arrowhead, Astra Zeneca, Denka Seiken, Esperion, Genentech, Illumina, Ionis, Eli Lilly, Merck, New Amsterdam, Novartis, Novo Nordisk, and Roche Diagnostic as a consultant; Pablo Corral: consulting and/or lecture fees from Novartis, Amgen, Novo Nordisk, MSD; Leslie J. Donato: lecture fees from Novartis and consultant fees from Bosch Healthcare Solutions GmbH; Ioanna Gouni-Berthold: consulting and/or lecture fees from Akcea, Amgen, Daiichi-Sankyo, Novartis, Sanofi-Regeneron, and Ultragenyx; Børge G. Nordestgaard: consultancies and talks sponsored by AstraZeneca, Sanofi, Regeneron, Ionis, Amgen, Amarin, Novartis, Novo Nordisk, Esperion, Lilly, Arrowhead, and Marea, and he is President of the European Atherosclerosis Society; Michel Langlois: lecture fees from Roche Diagnostics and Siemens Healthineers; Kausik K. Ray: unrestricted research grants to Imperial College London, Amgen, Sanofi, Regeneron, Daiichi Sankyo, and Ultragenix as well as consulting fees from Novartis, Daiichi Sankyo, Kowa, Esperion, Novo Nordisk, MSD, Lilly, Silence Therapeutics, AZ, New Amsterdam Pharma, Bayer, Beren Therapeutics, CLEERLY, EMENDOBIO, SCRIBE, CRISPR, VAXXINITY, Amarin, Regeneron, Ultragenix, Cargene, Resverlogix for serving as a member of the SC or EC of clinical trials and roles as PI, NLI; Honoraria from Novartis, BI, AZ, Novo Nordisk, Viatris, Amarin, Biologix Pharma, Sanofi, Amgen, Esperion, Daiichi Sankyo, Macleod Pharma for CME and non-CME symposia at international meetings; Stock options New Amsterdam Pharma, Scribe Therapeutics and PEMI 31; Raul D. Santos: consultancies, talks, and or research sponsored by Aché, Amgen, Amryt, Astra Zeneca, Arrowhead, Daiichi-Sankyo, Eli-Lilly, Esperion, Ionis, Kowa, Libbs, MSD, Novartis, Novo Nordisk, PTC Therapeutics, Torrent, Ultragenyx, and Sanofi/Regeneron; Erik SG Stroes: ab-board/consultancy fees paid to institution by NovoNordisk, Ionis, Ultragenyx, Amgen, Merck and Novartis; Hayato Tada: consulting and/or lecture fees from Novartis, Amgen, and Eli Lilly and Company; Michal Vrablik: consulting and/or lecture fees from Sanofi-Aventis, MSD, Boehringer-Ingelheim, AstraZeneca, Amgen, Novo Nordisk, Novartis, KRKA, Roche Diagnostics and Zentiva; Stephan J. Nicholls: grant/research support from AstraZeneca, NewAmsterdam Pharma, Amgen, Anthera, Cyclarity, Eli Lilly, Esperion, Novartis, Cerenis, The Medicines Company, Resverlogix, InfraReDx, Roche, Sanofi-Regeneron, and LipoScience as well as consultanting fees from Abcentra, AstraZeneca, Amarin, Akcea, Eli Lilly, Anthera, Omthera, Merck, Takeda, Resverlogix, Sanofi-Regeneron, CSL Behring, Esperion, Boehringer Ingelheim, Daiichi Sankyo, Silence Therapeutics, CSL Seqirus and Vaxxinity. All other authors report no conflicts of interest.
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