Liz covers cardiovascular and metabolic disease, asking why we’re not doing better or even losing ground against the world’s leading killer. Send tips on Signal at LizC.22.

Matthew Herper covers medical innovation — both its promise and its perils.

CHICAGO — Lipoprotein(a), a genetic risk factor for cardiovascular disease carried by 1 in 5 people, is the target of novel therapies trying to cut down heart attacks, strokes, and deaths in those at risk. The growing field of research aimed at the particle took a hit earlier this year when top-line results showed an experimental drug reduced Lp(a) but failed to lower serious outcomes.

More details of the study, funded by Novartis, were revealed Saturday at the American Heart Association’s scientific sessions and published simultaneously in the New England Journal of Medicine.

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In the Phase 3 trial, the drug pelacarsen dramatically lowered Lp(a), a mashup of lipids and proteins that at high levels can heighten the risk of severe heart problems. But despite lower Lp(a), the HORIZON trial showed no difference in heart attacks, strokes, urgent coronary revascularization, or deaths in participants followed for almost five years who were randomly selected to take the drug or a placebo.