Clinical trials to improve outcomes in patients with elevated Lp(a) undergoing PCI: The time has arrived

•Elevated Lp(a) is associated with adverse long-term outcomes in PCI. •Lp(a) carries OxPL, induces SMC proliferation and platelet pro-aggregatory effects. •Novel clinical trials of reducing Lp(a)-mediated risk are proposed. •ACS-DAPT-Lp(a) trial will test standard vs. prolonged dual anti-platelet therapy. •NIRS/IVUS/OCT-Lp(a) trial will assess Lp(a) lowering on lipid core burden index.