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Lipoprotein(a) in Atherosclerotic Diseases: From Pathophysiology to Diagnosis and Treatment

Stamatios Lampsas1, Maria Xenou1, Evangelos Oikonomou1

  • 13rd Department of Cardiology, National and Kapodistrian University of Athens, Medical School, Sotiria Chest Disease Hospital, 11527 Athens, Greece.

Molecules (Basel, Switzerland)
|February 11, 2023
PubMed

Insights

High lipoprotein(a) (Lp(a)) levels are a heritable risk factor for cardiovascular disease. This review summarizes Lp(a)

Area of Science:

  • Cardiovascular Medicine
  • Genetics
  • Biochemistry

Background:

  • Lipoprotein(a) (Lp(a)) is an LDL-like particle linked to apolipoprotein(a).
  • Elevated Lp(a) is an independent, heritable risk factor for atherosclerotic cardiovascular disease (ASCVD).
  • Lp(a) carries oxidized phospholipids (OxPL), promoting vascular inflammation and thrombosis.

Purpose of the Study:

  • To review the mechanisms by which Lp(a) influences inflammation, atherosclerosis, and thrombosis.
  • To discuss current diagnostic challenges and therapeutic strategies for managing Lp(a).

Main Methods:

  • This is a narrative review.
  • Information was synthesized from existing literature on Lp(a) function, measurement, and treatment.

Main Results:

  • Lp(a) significantly impacts vascular inflammation, lesion development, endothelial function, and thrombogenicity.
  • Current Lp(a) measurement methods lack global standardization.
  • Standard lipid-lowering therapies show limited efficacy in reducing Lp(a) levels.

Conclusions:

  • Lp(a) plays a critical role in the pathogenesis of ASCVD.
  • Standardization of Lp(a) measurement is essential for clinical practice.
  • Novel therapeutic approaches are needed to effectively lower Lp(a) and mitigate cardiovascular risk.

Keywords:
Lp(a)atherosclerotic diseasecardiovascular diseasegenetic variationsinflammationlipoprotein(a)thrombosistreatment

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