Temporal changes in lipoprotein(a) after acute coronary syndrome

Background and aims Lipoprotein(a) [Lp(a)] is an established independent risk factor for atherosclerotic cardiovascular disease and is traditionally considered stable. Its behavior following acute coronary syndrome (ACS) and clinical implications remain unclear. This study aimed to characterize the temporal trajectory of Lp(a) following ACS, evaluate whether baseline levels predict longitudinal changes, and assess the stability of clinically relevant Lp(a) risk categories. Methods In this prospective study, 225 patients with ACS underwent serial Lp(a) measurements during hospitalization and at follow-up (≥6 months). Longitudinal changes were assessed using linear mixed-effects models. Associations between baseline Lp(a) and changes over time were evaluated using Spearman correlation. Stability of Lp(a) threshold risk categories (