Novel Therapeutic Approaches for the Management of Elevated Lipoprotein(a): From Traditional Agents to Future...

Area of Science:

• Cardiology
• Biochemistry
• Pharmacology

Background:

• Cardiovascular disease remains the leading global cause of death.
• Residual cardiovascular risk persists despite effective low-density lipoprotein cholesterol (LDL-C) lowering therapies.
• Elevated plasma lipoprotein(a) (Lp(a)) is an independent risk factor, promoting inflammation and atherothrombosis.

Purpose of the Study:

• To review novel therapeutic strategies for effective lipoprotein(a) lowering.
• To discuss agents targeting residual cardiovascular risk in high-risk individuals.
• To evaluate current and emerging treatments for managing elevated Lp(a).

Main Methods:

• Literature review of existing and emerging therapeutic options.
• Analysis of agents affecting LDL receptor expression (statins, PCSK9 inhibitors).
• Evaluation of other treatment modalities including apheresis and genetic silencing therapies.

Main Results:

• Lipoprotein(a) contributes to cardiovascular risk via oxidized phospholipids and homology with plasminogen.
• Novel therapies aim to reduce Lp(a) levels, potentially offering personalized medicine approaches.
• Established and investigational agents are discussed for their efficacy in lowering Lp(a) and cardiovascular risk.

Conclusions:

• Effective Lp(a) lowering is crucial for managing residual cardiovascular risk.
• Emerging therapies, including antisense oligonucleotides and small interfering RNAs, show promise.
• Personalized medicine strategies targeting Lp(a) may significantly improve outcomes for high-risk patients.