# Lipoprotein(a) Biomarker · id `cardio:lipoprotein-a` · Cardiovascular Atlas · release `5dcd9b263fe17744` (public) > General information from published sources, not medical advice, and not reviewed by clinicians. Check the cited source before relying on anything here. The atlas's own text and curation may be reused under Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0, https://creativecommons.org/licenses/by-nc/4.0/): credit the atlas, and do not use it commercially. See the atlas About page. Text quoted from a source stays under that source's own terms, given as the source's reuse\_basis. The atlas's reuse terms do not cover it. The downloads list each quotation with its source in third\_party\_quotations. Also called: Lp(a) Browse, organ or system: Metabolism Browse, condition area: Coronary and vascular disease ## In plain language Lipoprotein(a), written Lp(a), is a cholesterol-carrying particle in the blood. Novartis says its level is about 90% set by genes and little changed by diet or lifestyle. In September 2026 Novartis reported that a large outcomes trial of pelacarsen, a medicine that lowers Lp(a), did not meet its main goal of reducing heart events. ## Technical summary The Lp(a)HORIZON registry record (NCT04023552) lists the condition as Cardiovascular Disease and Lipoprotein(a). On 4 September 2026 Novartis announced that the trial missed its primary endpoint (see the claim), so Lp(a) lowering with pelacarsen has not been shown to lower cardiovascular events. The full data had not been presented when this record was written. The 90% figure is a sponsor statement in a press release. MeSH has a heading for the particle. ## Claims, with the population each applies to ## Context: Adults with elevated Lp(a) and established cardiovascular disease (Lp(a)HORIZON) Recipient: Adult; Population: Patients with elevated Lp(a) and established cardiovascular disease. Novartis describes two analysis populations for the primary endpoint: everyone with Lp(a) of 70 mg/dL or more, and a subgroup with 90 mg/dL or more. The registry gives ages 18 to 80 years and enrollment of 8323.; Care setting: Global multicentre trial per the sponsor; site list not read; Geography: Global (sponsor wording); countries not read; Life stage: Adult, 18 to 80 years (registry); Follow-up: Not stated in the sources read. The registry gives completion on 2026-07-16. ### Novartis reported topline results on 4 September 2026 for Lp(a)HORIZON, a phase 3 outcomes trial of pelacarsen in adults with elevated Lp(a) and established cardiovascular disease: pelacarsen, compared with placebo, missed the trial primary endpoint, a four-part composite of cardiovascular death, heart attack, stroke and urgent coronary revascularization with hospital admission. Lp(a) fell on pelacarsen, but across all participants this was not shown to cut cardiovascular risk. The release gives no numbers and says full results will be shown at a future scientific meeting. The registry lists 8323 participants and completion on 2026-07-16. - Category: Effect - Evidence stage: Interventional - Certainty: Certainty not assessed - Applies to: Recipient: Adult; Population: Patients with elevated Lp(a) and established cardiovascular disease. Novartis describes two analysis populations for the primary endpoint: everyone with Lp(a) of 70 mg/dL or more, and a subgroup with 90 mg/dL or more. The registry gives ages 18 to 80 years and enrollment of 8323.; Care setting: Global multicentre trial per the sponsor; site list not read; Geography: Global (sponsor wording); countries not read; Life stage: Adult, 18 to 80 years (registry); Follow-up: Not stated in the sources read. The registry gives completion on 2026-07-16. - Limitations: This is a sponsor topline press release, not a peer-reviewed paper, and it gives no counts, hazard ratios or intervals. A PubMed title search on 2026-10-14 found commentary but no results paper (fetch log rows cg-status-pubmed-lpahorizon.json and cg-status-pubmed-summary.json). The release reports no separate result for the subgroup with Lp(a) of 90 mg/dL or more, although the primary endpoint was defined in both the overall population and that subgroup. The result may be refined when the full data are presented. The finding is for pelacarsen, one Lp(a)-lowering medicine, in people with established disease, and does not by itself settle whether other Lp(a)-lowering approaches would work. - Last checked: 2026-10-14 - Sources: 1. Supports: Novartis announces Lp(a)HORIZON Phase III topline results for pelacarsen in patients with elevated Lp(a) and established cardiovascular disease (CVD) (Webpage, edition Ad hoc announcement dated Basel, September 4, 2026. Page fetched 2026-10-14. A sponsor statement, not a peer-reviewed report: it gives no result numbers.) Locator: Press release, paragraph 1, sentence 1 (endpoint statement, first part). Retrieved 2026-10-14T18:26:10Z. Source state: Current. Snapshot hash: c334fcc8d8fe02bf04a340a71b88a0e3843f160501677562aab5dd978e5469ad. How it applies: Sponsor statement of the result and the first part of the composite. 2. Supports: Novartis announces Lp(a)HORIZON Phase III topline results for pelacarsen in patients with elevated Lp(a) and established cardiovascular disease (CVD) (Webpage, edition Ad hoc announcement dated Basel, September 4, 2026. Page fetched 2026-10-14. A sponsor statement, not a peer-reviewed report: it gives no result numbers.) Locator: Press release, paragraph 1, sentence 1 (endpoint statement, second part). Retrieved 2026-10-14T18:26:10Z. Source state: Current. Snapshot hash: c334fcc8d8fe02bf04a340a71b88a0e3843f160501677562aab5dd978e5469ad. How it applies: Rest of the primary endpoint wording. 3. Supports: Novartis announces Lp(a)HORIZON Phase III topline results for pelacarsen in patients with elevated Lp(a) and established cardiovascular disease (CVD) (Webpage, edition Ad hoc announcement dated Basel, September 4, 2026. Page fetched 2026-10-14. A sponsor statement, not a peer-reviewed report: it gives no result numbers.) Locator: Press release, paragraph 1, sentence 2. Retrieved 2026-10-14T18:26:10Z. Source state: Current. Snapshot hash: c334fcc8d8fe02bf04a340a71b88a0e3843f160501677562aab5dd978e5469ad. How it applies: Lp(a) lowering reported by the sponsor. 4. Supports: Novartis announces Lp(a)HORIZON Phase III topline results for pelacarsen in patients with elevated Lp(a) and established cardiovascular disease (CVD) (Webpage, edition Ad hoc announcement dated Basel, September 4, 2026. Page fetched 2026-10-14. A sponsor statement, not a peer-reviewed report: it gives no result numbers.) Locator: Press release, paragraph 2, statement of the Chief Medical Officer. Retrieved 2026-10-14T18:26:10Z. Source state: Current. Snapshot hash: c334fcc8d8fe02bf04a340a71b88a0e3843f160501677562aab5dd978e5469ad. How it applies: Sponsor interpretation. 5. Supports: Novartis announces Lp(a)HORIZON Phase III topline results for pelacarsen in patients with elevated Lp(a) and established cardiovascular disease (CVD) (Webpage, edition Ad hoc announcement dated Basel, September 4, 2026. Page fetched 2026-10-14. A sponsor statement, not a peer-reviewed report: it gives no result numbers.) Locator: Press release, paragraph 3. Retrieved 2026-10-14T18:26:10Z. Source state: Current. Snapshot hash: c334fcc8d8fe02bf04a340a71b88a0e3843f160501677562aab5dd978e5469ad. How it applies: Full data not yet released. 6. Supports: Novartis announces Lp(a)HORIZON Phase III topline results for pelacarsen in patients with elevated Lp(a) and established cardiovascular disease (CVD) (Webpage, edition Ad hoc announcement dated Basel, September 4, 2026. Page fetched 2026-10-14. A sponsor statement, not a peer-reviewed report: it gives no result numbers.) Locator: Press release, dateline. Retrieved 2026-10-14T18:26:10Z. Source state: Current. Snapshot hash: c334fcc8d8fe02bf04a340a71b88a0e3843f160501677562aab5dd978e5469ad. How it applies: Date of the statement. 7. Background: Assessing the Impact of Lipoprotein (a) Lowering With Pelacarsen (TQJ230) on Major Cardiovascular Events in Patients With CVD (Registry, edition ClinicalTrials.gov API v2 record, last update posted 2026-08-28.) Locator: protocolSection.identificationModule.officialTitle: "A Randomized Double-blind, Placebo-controlled, Multicenter Trial Assessing the Impact of Lipoprotein (a) Lowering With Pelacarsen (TQJ230)". Retrieved 2026-10-14T18:18:40Z. Source state: Current. Snapshot hash: f07058e6a56963b4a23bf9927f9651d03a4ed25bf48234708ac8dc88e1ede929. How it applies: Registry title: placebo-controlled, double-blind. 8. Background: Assessing the Impact of Lipoprotein (a) Lowering With Pelacarsen (TQJ230) on Major Cardiovascular Events in Patients With CVD (Registry, edition ClinicalTrials.gov API v2 record, last update posted 2026-08-28.) Locator: protocolSection.identificationModule.officialTitle: "on Major Cardiovascular Events in Patients With Established Cardiovascular Disease". Retrieved 2026-10-14T18:18:40Z. Source state: Current. Snapshot hash: f07058e6a56963b4a23bf9927f9651d03a4ed25bf48234708ac8dc88e1ede929. How it applies: Registry title, population. 9. Supports: Assessing the Impact of Lipoprotein (a) Lowering With Pelacarsen (TQJ230) on Major Cardiovascular Events in Patients With CVD (Registry, edition ClinicalTrials.gov API v2 record, last update posted 2026-08-28.) Locator: protocolSection.designModule.enrollmentInfo.count: "8323". Retrieved 2026-10-14T18:18:40Z. Source state: Current. Snapshot hash: f07058e6a56963b4a23bf9927f9651d03a4ed25bf48234708ac8dc88e1ede929. How it applies: Registry enrollment count. 10. Supports: Assessing the Impact of Lipoprotein (a) Lowering With Pelacarsen (TQJ230) on Major Cardiovascular Events in Patients With CVD (Registry, edition ClinicalTrials.gov API v2 record, last update posted 2026-08-28.) Locator: protocolSection.statusModule.completionDateStruct.date: "2026-07-16". Retrieved 2026-10-14T18:18:40Z. Source state: Current. Snapshot hash: f07058e6a56963b4a23bf9927f9651d03a4ed25bf48234708ac8dc88e1ede929. How it applies: Registry completion date. ## Connected pages - Under study as a separate cause: Coronary artery disease (`cardio:coronary-artery-disease`) ## Provenance Content hash: 65850b154af6a81d57a8594100f37fb053916df5ac72574b69e3f9d81b659606 Last substantive edit: 2026-10-14 Evidence last checked: 2026-10-14