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Lp(a) - an overlooked risk factor

Luke J Laffin1, Steven E Nissen1

  • 1Cleveland Clinic Foundation, Cleveland, Ohio, USA.

Trends in Cardiovascular Medicine
|January 21, 2023
PubMed

Insights

Lipoprotein(a) (Lp(a)) is a genetic risk factor for cardiovascular disease affecting up to 30% of people. Research is exploring therapies to lower Lp(a) and reduce cardiovascular events.

Area of Science:

  • Cardiology
  • Genetics
  • Epidemiology

Background:

  • Lipoprotein(a) (Lp(a)) is a significant risk factor for atherosclerotic cardiovascular disease and aortic valve stenosis.
  • Genetic and epidemiological studies confirm Lp(a)'s causal role in cardiovascular disease incidence.
  • Elevated Lp(a) affects an estimated 20-30% of the global population.

Purpose of the Study:

  • To review the genetics and pathophysiology of Lp(a).
  • To discuss epidemiological data on Lp(a) and cardiovascular disease.
  • To outline current screening recommendations and emerging pharmacotherapies for Lp(a) lowering.

Main Methods:

  • Review of genetic and epidemiological studies.
  • Analysis of pathophysiological mechanisms.
  • Survey of ongoing and developing pharmacotherapies.

Main Results:

  • Lp(a) levels are primarily genetically determined and resistant to lifestyle changes.
  • Significant evidence supports Lp(a) as a causal factor in cardiovascular disease.
  • Multiple pharmacotherapies targeting Lp(a) reduction are under development.

Conclusions:

  • Lp(a) is a prevalent, genetically driven risk factor for cardiovascular disease.
  • Effective screening and management strategies are crucial.
  • Pharmacological Lp(a) lowering holds promise for reducing cardiovascular events.

Keywords:
HypercholesterolemiaHyperlipidemiaLipidsLipoprotein(a)Risk factors

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