Lp(a)HORIZON Trial: Pelacarsen Lowered Lipoprotein(a) by an Average of 78%, With Major Cardiovascular Events at 12.3% Versus 12.1%
CHICAGO, Cook County, Illinois — Results of the phase III Lp(a)HORIZON trial, presented on November 7 at the American Heart Association's Scientific Sessions 2026 in Chicago, showed that the novel medication pelacarsen lowered lipoprotein(a) [Lp(a)] levels by a mean of 78% in adults with elevated Lp(a) and established cardiovascular disease, but did not change the time to a major adverse cardiovascular event. The primary analysis was published simultaneously in the New England Journal of Medicine, with extended analyses in NEJM Evidence.
According to the American Heart Association's release, the trial randomized 8,350 adults at 797 sites in 42 countries, with 8,322 included in the efficacy analysis; participants had baseline Lp(a) of at least 70 mg/dL. At 12 months, Lp(a) had fallen by 78.4% with pelacarsen and 3.2% with placebo, a difference of 77.7 percentage points. Over a median follow-up of 4.7 years, the primary composite endpoint — cardiovascular death, nonfatal heart attack, nonfatal stroke or urgent coronary revascularization — occurred in 12.3% of the pelacarsen group (511 of 4,157) and 12.1% of the placebo group (503 of 4,165), a hazard ratio of 1.02 that was not statistically significant; no subgroup benefited, including patients with the highest baseline Lp(a), at or above 90 mg/dL.
Senior author Steven E. Nissen, M.D., FAHA, chief academic officer of the Miller Family Heart, Vascular & Thoracic Institute at Cleveland Clinic, said pelacarsen improved Lp(a) measures significantly — 78% lower — while cardiovascular outcomes were unchanged, calling the neutral finding unexpected and surprising to the medical community; the researchers also urge everyone to have their Lp(a) levels measured to help estimate cardiovascular risk. This report presents only the published trial data and the investigators' statements and does not constitute medical advice for any individual.
(Source: American Heart Association)
Source: American Heart Association
Published by GSM · USA (original Chinese edition)
Photo: 图：冠状动脉 CT 成像（资料图）。Goleisureintl 摄，CC BY 4.0，经 Wikimedia Commons。 / Photo: CT coronary artery imaging (file photo). Photo by Goleisureintl, CC BY 4.0, via Wikimedia Commons.
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