# Aspirin, Lp(a) and Primary Prevention of Cardiovascular Events

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA, SAN DIEGO · 2024 · $757,829

## Abstract

PROJECT Summary
 Lp(a) is a highly prevalent, independent, genetic and likely causal risk factor for cardiovascular disease.
The population at risk represents 20-30% of individuals in the United States, or >100,000,000 people, and an
estimated 1.4 billion people globally. Lp(a) is associated with increased CVD risk in primary prevention settings
and in patients on statins and PCSK9 inhibitors in secondary prevention settings. Lp(a) is a preferential carrier of
OxPL, the content of which in plasma can be measured by the assay OxPL-apoB. There are no approved
pharmacological therapies to treat elevated Lp(a). In primary prevention settings, clinical equipoise exists in the
use of aspirin in adults with elevated Lp(a) (>30 mg/dL or >75 nmol/L), and physicians do not have enough
information to treat such patients with aspirin, particularly those with a strong family history of CVD. We hypothesize
that elevated Lp(a) will identify a large subgroup of individuals that may benefit from aspirin in primary prevention
settings and propose to test this hypothesis in the ASPREE and ASCEND trials. We propose to test the hypothesis
that aspirin modifies the risk of incident atherothrombotic CVD events in high-risk primary prevention settings to a
different extent in people with high Lp(a) or OxPL-apoB levels than in people with lower Lp(a) levels. SubAim 1 will
test this hypothesis in elderly individuals in the ASPREE trial. SubAim 2 will test this hypothesis in individuals with
type 2 diabetes in the ASCEND trial. We will also perform a meta-analyses of the effects of aspirin on the risk of
incident atherothrombotic CVD events in high-risk primary prevention settings in people with high versus lower
Lp(a) levels and in people with high versus lower OxPL-apoB levels in the ASPREE and ASCEND trials, using the
most comprehensive relevant outcome in each trial, as used in Aim 1 and Aim 2.

## Key facts

- **NIH application ID:** 10910186
- **Project number:** 5R01HL170224-02
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN DIEGO
- **Principal Investigator:** SOTIRIOS TSIMIKAS
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $757,829
- **Award type:** 5
- **Project period:** 2023-09-01 → 2027-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10910186

## Citation

> US National Institutes of Health, RePORTER application 10910186, Aspirin, Lp(a) and Primary Prevention of Cardiovascular Events (5R01HL170224-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10910186. Licensed CC0.

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