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Emerging Pharmacotherapy to Reduce Elevated Lipoprotein(a) Plasma Levels

Nathaniel Eraikhuemen1, Dovena Lazaridis2, Matthew T Dutton3

  • 1College of Pharmacy and Pharmaceutical Sciences, Institute of Public Health, Florida A&M University, Davie, FL, 33324, USA.

American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions
|September 15, 2020
PubMed

Insights

Elevated Lipoprotein(a) levels increase the risk of premature cardiovascular disease. Emerging therapies show promise for managing high Lipoprotein(a) where statins fail.

Area of Science:

  • Cardiovascular Medicine
  • Lipid Metabolism
  • Atherosclerosis Research

Background:

  • Lipoprotein(a) [Lp(a)] is a modified low-density lipoprotein linked to premature atherosclerotic diseases.
  • High Lp(a) levels correlate with increased incidence of coronary artery disease, myocardial infarction, and stroke.
  • Lp(a) plasma levels and activity vary significantly due to apolipoprotein A kringle repeat variability.

Purpose of the Study:

  • To review the role of Lipoprotein(a) in atherogenesis.
  • To discuss the limitations of current therapies for elevated Lp(a).
  • To highlight emerging pharmacologic strategies for managing high Lp(a) levels.

Main Methods:

  • Literature review of Lipoprotein(a) function and clinical impact.
  • Analysis of current and novel lipid-lowering therapies.
  • Synthesis of evidence on Lp(a)-associated cardiovascular risk.

Main Results:

  • Lipoprotein(a) is present in arterial walls and contributes to foam cell formation and lipid deposition in atherosclerotic plaques.
  • Conventional lipid-lowering drugs like statins are ineffective at reducing Lp(a) levels.
  • Novel agents, including PCSK9 inhibitors and antisense oligonucleotides, demonstrate potential for Lp(a) management.

Conclusions:

  • Lipoprotein(a) is a significant, independent risk factor for premature cardiovascular events.
  • Effective pharmacologic management of elevated Lp(a) requires novel therapeutic approaches beyond traditional lipid-lowering agents.
  • Emerging therapies offer new hope for reducing cardiovascular risk in individuals with high Lp(a).

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