Lipoprotein (A) in clinical practice

Area of Science:

• Cardiovascular Medicine
• Clinical Biochemistry
• Genetics

Background:

• Lipoprotein (a) [Lp(a)] is an independent risk factor for atherosclerosis, ischemic heart disease, and stroke.
• The Lp(a) subtype is genetically linked to the Apo(a) gene on chromosome 6q26-27, increasing coronary artery disease (CAD) risk.
• Despite established links, clinical relevance and application in cardiovascular prevention require further clarification.

Purpose of the Study:

• To systematically review the scientific literature on Lipoprotein (a) from 1960 to 2012.
• To assess the clinical relevance of Lp(a) in cardiovascular disease (CVD) risk and prevention.
• To evaluate potential management strategies for elevated Lp(a) levels.

Main Methods:

• Systematic literature review of data sources including Cochrane, PubMed, and MEDLINE.
• Analysis of studies published between 1960 and 2012.
• Focus on Lp(a) as a risk factor for atherosclerotic cardiovascular disease.

Main Results:

• Plasma Lp(a) measurement is indicated in patients with premature coronary disease without identified causes.
• Emerging management strategies include PCSK9 inhibitors, apheresis, CETP inhibitors, dietary changes, and ACE inhibitors.
• Clear evidence confirms Lp(a) as a definitive risk marker for atherosclerotic CVD.

Conclusions:

• Lipoprotein (a) is a validated risk marker for atherosclerotic cardiovascular disease.
• Further research is needed to fully elucidate the clinical utility of Lp(a) in cardiovascular prevention.
• Personalized risk assessment and management strategies targeting Lp(a) show promise.