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Lipoprotein(a)--An independent causal risk factor for cardiovascular disease and current therapeutic options

Ursula Kassner1, Thomas Schlabs2, Adrian Rosada3

  • 1Outpatient Clinic for Lipid Metabolism Disorders, Interdisciplinary Metabolism Center, Charité - Universitaetsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany.

Atherosclerosis. Supplements
|May 5, 2015
PubMed

Insights

Elevated lipoprotein(a) (Lp(a)) increases cardiovascular disease risk. While therapies are developing, only apheresis currently lowers Lp(a), but its risk reduction efficacy requires more study.

Area of Science:

  • Cardiology
  • Biochemistry

Background:

  • Elevated lipoprotein(a) (Lp(a)) is a recognized cardiovascular disease risk factor.
  • Lp(a) is an independent predictor of cardiovascular events.
  • Therapeutic strategies aim to reduce serum Lp(a) levels.

Purpose of the Study:

  • To review current scientific evidence on Lp(a) and cardiovascular risk.
  • To examine existing and developing therapies for lowering Lp(a).
  • To assess the proven efficacy of Lp(a) reduction in cardiovascular risk.

Main Methods:

  • Review of scientific literature on Lp(a) and cardiovascular disease.
  • Analysis of current therapeutic developments targeting Lp(a).
  • Evaluation of evidence for Lp(a) lowering therapies, including apheresis.

Main Results:

  • No pharmaceutical treatments to lower Lp(a) are currently approved in Europe.
  • Promising results observed with apolipoprotein-(B-100)-antisense mipomersen, PCSK9 inhibitors, and apolipoprotein-(a)-antisense.
  • Extracorporeal lipoprotein apheresis effectively reduces Lp(a) by 60-70% per session.
  • Lack of randomized, controlled studies proving cardiovascular risk reduction from Lp(a) lowering, except for one small study.

Conclusions:

  • Lp(a) remains a significant, modifiable cardiovascular risk factor.
  • Apolipoprotein-(a)-antisense and other emerging therapies show potential for Lp(a) reduction.
  • Further robust clinical trials are essential to confirm the cardiovascular benefits of lowering Lp(a).

Keywords:
Cardiovascular diseaseLipoprotein apheresisLipoprotein(a)

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