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Lipoprotein(a) and Cardiovascular Disease

Pia R Kamstrup1,2

  • 1Department of Clinical Biochemistry.

Clinical Chemistry
|November 25, 2020
PubMed

Insights

High lipoprotein(a) levels significantly increase cardiovascular disease risk, impacting over a billion people. Current treatments do not target lipoprotein(a), highlighting an unmet medical need for effective therapies.

Area of Science:

  • Cardiology
  • Genetics
  • Epidemiology

Background:

  • High lipoprotein(a) concentrations affect 10%-20% of the population.
  • A causal link to ischemic cardiovascular disease is suspected.
  • Lipoprotein(a) is not currently a therapeutic target for cardiovascular disease prevention.

Purpose of the Study:

  • To review evidence supporting a causal role of lipoprotein(a) in cardiovascular disease.
  • To discuss lipoprotein(a) measurement methods.
  • To explore future therapeutic strategies for lowering lipoprotein(a).

Main Methods:

  • Review of genetic epidemiologic studies.
  • Analysis of mechanistic and observational data.
  • Discussion of validated lipoprotein(a) assays.

Main Results:

  • Strong evidence from genetic, mechanistic, and observational studies supports a causal role of lipoprotein(a) in cardiovascular disease, including coronary heart disease, peripheral arterial disease, aortic valve stenosis, and ischemic stroke.
  • High lipoprotein(a) predicts 2- to 3-fold increased risk for myocardial infarction, peripheral arterial disease, and aortic valve stenosis.
  • Accurate lipoprotein(a) measurement requires validated assays traceable to a common calibrator.

Conclusions:

  • Lipoprotein(a) is causally linked to cardiovascular disease development.
  • Standardized, validated assays are crucial for risk assessment.
  • Further research, including randomized trials, is needed to evaluate lipoprotein(a)-lowering therapies.
Abstract

Keywords:
cardiovascular diseasegenelipoprotein(a)measurements

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