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Lipoprotein(a): a promising marker for residual cardiovascular risk assessment

Anping Cai1, Liwen Li, Ying Zhang

  • 1Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China.

Disease Markers
|November 20, 2013
PubMed

Insights

Lipoprotein(a) (Lp(a)) is a significant risk factor for atherosclerotic cardiovascular diseases (CVD) even with optimal medical therapy. Elevated Lp(a) may indicate residual cardiovascular risk, suggesting potential benefits from more aggressive LDL-C lowering.

Area of Science:

  • Cardiology
  • Atherosclerosis Research
  • Lipidology

Background:

  • Atherosclerotic cardiovascular diseases (CVD) remain a leading global cause of death and disability.
  • Optimal medical therapy often fails to eliminate residual cardiovascular risk in certain patient groups, particularly those with normal low-density lipoprotein-cholesterol (LDL-C) levels.
  • Lipoprotein(a) (Lp(a)) has emerged as a key independent risk factor for CVD due to its proatherogenic and prothrombotic properties.

Purpose of the Study:

  • To highlight the significance of lipoprotein(a) (Lp(a)) as a marker for residual cardiovascular risk.
  • To discuss the challenges in developing effective Lp(a)-lowering therapies.
  • To propose potential therapeutic strategies for patients with high Lp(a) levels.

Main Methods:

  • Review of clinical trials and meta-analyses on Lp(a) and cardiovascular risk.
  • Analysis of Lp(a)'s role in atherosclerosis and thrombosis.
  • Evaluation of current treatment guidelines and their limitations.

Main Results:

  • Compelling evidence identifies Lp(a) as a significant contributor to residual cardiovascular risk.
  • The lack of specific Lp(a)-lowering medications hinders large-scale clinical trials.
  • Lp(a) can identify individuals at high risk, even with controlled LDL-C.

Conclusions:

  • Lipoprotein(a) is a crucial factor in assessing residual cardiovascular risk.
  • Aggressively lowering LDL-C may be beneficial for patients with high Lp(a) levels.
  • Further research into Lp(a)-targeted therapies is warranted.

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