Inclusion Criteria:  concentration Lp (a) above 700 mg / L, optimally treated risk factors for cardiovascular events according to currently valid guidelines, history of myocardial infarction having occurred in the period 3 months to 10 years prior to the screening visit and / or history of ischemic stroke having occurred in the period 3 months to 10 years prior to the screening visit and / or clinically significant symptomatic peripheral artery disease.  Exclusion Criteria:  uncontrolled hypertension (systolic blood pressure ≥ 160 mmHg and / or diastolic blood pressure ≥ 100 mmHg), heart failure New York Heart Association (NYHA) class IV, history of malignancy of any organ system, history of hemorrhagic stroke or other major bleeding, platelet count <140,000 per mm3, active liver disease or hepatic dysfunction (elevated transaminases above 3 times the norm, elevated bilirubin above 2 times the norm, elevated creatinine kinase above 3 times the norm), significant kidney disease (oGFR <30 ml / min), pregnant or nursing women, life expectancy less than 5 years, unwillingness to participate or lack of availability for follow-up.