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Lipoprotein (a), Inflammation, and Atherosclerosis

Stefania Angela Di Fusco1, Aldo Pietro Maggioni2, Pietro Scicchitano3

  • 1Clinical and Rehabilitation Unit, San Filippo Neri Hospital, ASL Rome 1, 00135 Rome, Italy.

Journal of Clinical Medicine
|April 13, 2023
PubMed

Insights

High levels of lipoprotein (a) and chronic inflammation contribute to residual cardiovascular risk. Targeting these factors may reduce future cardiovascular events in patients.

Area of Science:

  • Cardiovascular Medicine
  • Biochemistry
  • Inflammation Research

Background:

  • Residual cardiovascular risk persists despite optimal evidence-based management.
  • Elevated lipoprotein (a) (Lp(a)) and chronic inflammation are implicated in this residual risk.
  • Lp(a) >125 nmol/L and high-sensitivity C-reactive protein >2 mg/dL are associated with increased cardiovascular events.

Purpose of the Study:

  • To review the role of lipoprotein (a) and chronic inflammation in residual cardiovascular risk.
  • To discuss current therapeutic limitations and emerging strategies for these risk factors.
  • To highlight the importance of improved risk stratification for atherosclerotic cardiovascular disease.

Main Methods:

  • Review of clinical studies and evidence linking Lp(a) and inflammation to cardiovascular disease.
  • Analysis of current lipid-lowering drug efficacy on Lp(a) levels.
  • Examination of anti-inflammatory drugs (e.g., canakinumab, colchicine) in cardiovascular risk reduction.

Main Results:

  • High Lp(a) levels correlate with ischemic heart disease, stroke, and aortic stenosis.
  • Standard lipid-lowering drugs have minimal effect on Lp(a).
  • Canakinumab and colchicine show potential for cardiovascular risk reduction by targeting inflammation.

Conclusions:

  • Lipoprotein (a) and chronic inflammation are key contributors to residual cardiovascular risk.
  • Novel diagnostic and therapeutic strategies targeting Lp(a) and inflammation are crucial.
  • Refined patient management through risk stratification may reduce atherosclerotic cardiovascular disease burden.

Keywords:
cardiovascular preventioncolchicineinflammationlipoprotein (a)personalized medicine

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