When do you check Lp(a) in patients with a first-time ischemic stroke?

I don’t routinely check Lp(a) in my stroke patients, including first-time cryptogenic stroke patients. Evidence suggests that the elevated Lp(a) amplifies cardiovascular risk in patients with pre-existing atherosclerosis due to LDL-C. We already have high-quality evidence that in patients with strok...

While there are effective drugs to reduce Lp(a), so far, no efficacy trials - very similar to the homocysteine era. I check Lp(a) when there is no other explainable cause and am trying to put together an efficacy trial. As of now, it may be worth looking at ESUS and strokes of unknown etiology.