Elevated Lp(a) is not always present in individuals at high cardiovascular risk, suggesting other unelucidated genetic factors.

“he does not have an elevated LP little a but his family history is really significant for cardiovascular disease this is a patient in fact who I said to him I said if I would have bet stupid sums of money have I without seeing your labs that you had an elevated LP little a because for all for all intensive purposes he looks like someone who would have an elevated LP little 8 and he doesn't which again speaks to just the complexity of the disease and there are undoubtedly other genetic factors because clearly this is genetic that we haven't yet they know elucidated”