{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T17:09:45Z","timestamp":1789578585154,"version":"build-2803163510"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T00:00:00Z","timestamp":1768262400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:p>Elevated plasma lipoprotein(a) [Lp(a)] is a causal risk factor for the development of atherosclerotic cardiovascular disease (ASCVD). However, commonly used ASCVD clinical risk-assessment tools in primary care do not include the measurement of Lp(a) levels, potentially under-estimating individual risk. Here we describe the case of a late-40s, asymptomatic, normotensive, non-smoking veteran athlete with a moderately raised low density lipoprotein cholesterol (LDL-C) level and a calculated 10-year QRISK3 score of 4.1%. Despite his low calculated QRISK3 score, significantly elevated Lp(a) levels led to advanced cardiovascular imaging, which revealed severe stenosis (75%, CAD-RADS 4A) of the left anterior descending coronary artery. This case demonstrates the limitations of conventional cardiovascular risk tools and highlights the importance of Lp(a) measurement for identifying and managing high-risk patients.<\/jats:p>","DOI":"10.3389\/fcvm.2025.1688597","type":"journal-article","created":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T06:30:10Z","timestamp":1768285810000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Case Report: Elevated Lp(a) as a cause of severe ASCVD in a healthy veteran athlete with low calculated QRISK3 score"],"prefix":"10.3389","volume":"12","author":[{"given":"Jonathan","family":"Clark-McKellar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracey","family":"Keteepe-Arachi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Fitzgerald","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark W.","family":"Ruddock","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1670","DOI":"10.1016\/S0140-6736(10)61350-5","article-title":"Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials","volume":"376","author":"Baigent","year":"2010","journal-title":"Lancet"},{"key":"B2","doi-asserted-by":"publisher","first-page":"88","DOI":"10.3389\/fcvm.2020.00088","article-title":"The evolving understanding and approach to residual cardiovascular risk management","volume":"7","author":"Dhindsa","year":"2020","journal-title":"Front Cardiovasc Med"},{"key":"B3","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1016\/j.atherosclerosis.2018.04.032","article-title":"Is Lp(a) ready for prime time use in the clinic? 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