Related Experiment Video
Updated: Jul 5, 2025
Isolation and Analysis of Plasma Lipoproteins by Ultracentrifugation
Published on: January 28, 2021
[Lipoprotein(a): relationships with atherosclerosis and valvular heart disease, and emerging therapies]
Maurizio Giuseppe Abrignani1, Alessandro Maloberti2, Stefania Angela Di Fusco3
1U.O.C. Cardiologia, P.O. P. Borsellino, Marsala, ASP Trapani.
Insights
Lipoprotein(a) [Lp(a)] is a key cardiovascular risk factor linked to atherosclerosis. New therapies aim to lower Lp(a) levels, but their impact on cardiovascular events requires further study.
Area of Science:
- Biochemistry
- Genetics
- Cardiology
Context:
- Lipoprotein(a) [Lp(a)] is a significant, genetically determined risk factor for atherosclerotic cardiovascular disease.
- Its pro-atherogenic, pro-thrombotic, and pro-inflammatory properties contribute to disease development.
- Lp(a) is the most common monogenic risk factor for atherosclerosis, affecting approximately 20% of the population.
Purpose:
- To review the established role of Lp(a) in cardiovascular disease.
- To explore the emerging suspected link between Lp(a) and valvular heart disease, specifically aortic and mitral stenosis.
- To discuss the current limitations in modifying Lp(a) levels and the investigation of novel therapies.
Summary:
- Epidemiological, genetic, and meta-analysis studies confirm Lp(a) as a major contributor to atherosclerotic disease.
- Emerging evidence suggests a potential role for Lp(a) in calcific and degenerative valvular heart diseases.
- Lp(a) has historically been considered non-modifiable, with limited efficacy of current lipid-lowering drugs.
Impact:
- Novel Lp(a)-lowering therapies are under investigation in clinical trials.
- The clinical benefit of reducing Lp(a) levels on cardiovascular outcomes remains an active area of research.
- Understanding Lp(a)'s role is crucial for developing targeted prevention and treatment strategies for cardiovascular and valvular heart diseases.
Abstract:
Lipoprotein(a) [Lp(a)] is a well-established cardiovascular risk factor, whose relationship with atherosclerotic disease has been confirmed by epidemiological, genome-wide association, Mendelian randomization, and meta-analysis studies. This association is determined by its pro-atherogenic, pro-thrombotic and pro-inflammatory properties. Lp(a) is the most common monogenic risk factor for atherosclerosis, with a prevalence of about 1 in 5 people. Recently, its etiopathogenetic relationship with calcific and degenerative valvular heart diseases, particularly with aortic and mitral stenosis, has been suspected. It has not yet been demonstrated whether its reduction translates into a lower risk of cardiovascular events. Up to now, Lp(a) has been considered a non-modifiable risk factor, as current lipid-lowering drugs have limited effects on its levels. New specific lipid-lowering therapies with high efficacy in reducing circulating Lp(a) levels are being investigated in randomized trials; however, the effects of this reduction on cardiovascular outcomes are still being studied.
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