Extremely high plasma Lp(a) concentrations (>95th percentile) are associated with the highest risk of ASCVD (Kamstrup et al., 2008; Burgess et al., 2018; Loh et al., 2021), CAVD (Kamstrup et al., 2014; Guddeti et al., 2020), and heart failure (Kamstrup and Nordestgaard, 2016) in the general population. This evidence concerns the gene LPA and congenital bilateral aplasia of vas deferens from CFTR mutation.