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Should we Consider Lipoprotein (a) in Cardiovascular Disease Risk Assessment in Patients with Familial

Panagiotis Anagnostis1,2, Pavlos Siolos2, Dimitrios Krikidis3

  • 1Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynaecology, Medical School, Aristotle University of Thessaloniki, Greece.

Current Pharmaceutical Design
|October 16, 2018
PubMed

Insights

Familial hypercholesterolaemia (FH) patients have elevated Lipoprotein (a) [Lp(a)] levels, a key factor in cardiovascular disease (CVD) risk. Understanding Lp(a) is crucial for managing FH and preventing CVD.

Area of Science:

  • Cardiovascular Medicine
  • Genetics
  • Lipidology

Background:

  • Familial hypercholesterolaemia (FH) is a genetic lipid disorder affecting 1 in 200-500 people.
  • FH significantly increases Cardiovascular Disease (CVD) risk but is often underdiagnosed and undertreated.
  • Lipoprotein (a) [Lp(a)] is an LDL-like molecule with an additional apolipoprotein (a).

Purpose of the Study:

  • To review and discuss existing data on Lp(a) in FH patients.
  • To evaluate the role of Lp(a) in augmenting CVD risk within the FH population.

Main Methods:

  • A comprehensive literature search was conducted.
  • Studies focused on evaluating the cardiovascular effects of Lp(a) in FH patients.

Main Results:

  • Lp(a) is an established independent risk factor for CVD, particularly coronary artery disease (CAD).
  • Elevated Lp(a) concentrations are observed in most adults and children with FH.
  • An independent association exists between Lp(a) and CVD (primarily CAD) risk in FH patients.

Conclusions:

  • Therapeutic agents like niacin, oestrogens, tibolone, and PCSK9 inhibitors can reduce Lp(a) by 25-30%.
  • The clinical benefit of Lp(a) reduction with these therapies requires further establishment.
Abstract

Keywords:
Familial hypercholesterolaemiaapolipoprotein (a)cardiovascular diseasecoronary artery diseaselipoprotein (a)oestrogens.

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