Clinical Relevance of Lipoprotein(a) in Young Acute Myocardial Infarction: STEMI vs. NSTEMI

The incidence of acute myocardial infarction (AMI) in young adults has been steadily rising, emphasizing the need for new biomarkers to improve risk stratification. Lipo-protein(a) (Lp(a)), a genetically determined lipoprotein with pro-atherogenic and pro-thrombotic properties, has gained increasing attention in this context. Our findings show that elevated Lp(a) levels are significantly more common in young patients with AMI compared with healthy controls. Importantly, Lp(a) ≥30 mg/dL was strongly associated with multivessel coronary artery disease in NSTEMI, conferring more than a fourfold increased risk. In STEMI, its effect was weaker and largely influenced by concomitant factors such as diabetes and elevated LDL cholesterol. These results underline key pathophysiological differences between infarct phe-notypes and position Lp(a) as a particularly relevant biomarker in young NSTEMI pa-tients. Systematic assessment of Lp(a) may enhance coronary risk stratification and support more tailored secondary prevention strategies.