•Elevated Lp(a) levels above guideline (≥125 nmol/L) and trial-based (≥150 nmol/L) thresholds were associated with nearly 2-fold higher risk of AAA (OR: 1.82 and 1.93, respectively; both P < 0.001), compared with individuals below these thresholds. The gene discussed is LPA; the disease is triple-A syndrome.