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JCL roundtable-Lipoprotein(a): The emerging risk factor

Santica M Marcovina1, Patrick M Moriarty2, Marlys L Koschinsky3

  • 1University of Washington, Seattle, WA, USA.

Journal of Clinical Lipidology
|December 12, 2018
PubMed

Insights

Lipoprotein(a) (Lp(a)) is a key risk factor for cardiovascular events and calcific aortic stenosis. Emerging therapies show promise in significantly lowering Lp(a) levels, offering new clinical strategies.

Area of Science:

  • Cardiovascular Medicine
  • Genetics
  • Pharmacology

Background:

  • Lipoprotein(a) (Lp(a)) is a significant risk factor for atherothrombotic events, comparable to LDL cholesterol.
  • Lp(a) is implicated in the progression of calcific aortic stenosis and arterial strokes, even without atherosclerosis.
  • Understanding Lp(a) inheritance and apolipoprotein(a) structure-function is advancing.

Purpose of the Study:

  • To review the role of Lipoprotein(a) in cardiovascular diseases.
  • To explore the interaction between Lp(a), oxidized phospholipids, and inflammatory markers.
  • To discuss novel pharmaceutical strategies for Lp(a) reduction and clinical management.

Main Methods:

  • Review of current literature on Lp(a) genetics, function, and clinical impact.
  • Discussion of recent findings on Lp(a) interactions with inflammatory pathways.
  • Analysis of emerging antisense and RNA interference technologies for Lp(a) lowering.

Main Results:

  • Lp(a) levels are strongly inherited, with apolipoprotein(a) structure influencing function.
  • Interactions between oxidized phospholipids on Lp(a) and interleukin-1 genotypes are observed.
  • New therapies, including antisense and RNA interference, can reduce Lp(a) by up to 90%.

Conclusions:

  • Lipoprotein(a) is a critical, actionable target for cardiovascular risk reduction.
  • Novel therapeutic approaches offer unprecedented potential for lowering Lp(a) levels.
  • Clinical measurement and management strategies for Lp(a) are evolving.

Keywords:
AtherothrombosisCalcific aortic stenosisCardiovascular riskChildhood strokeLipoprotein(a)

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