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Lipoprotein (a) and cerebrovascular disease

Constantine E Kosmas1, Maria D Bousvarou2, Evangelia J Papakonstantinou3

  • 12nd Department of Cardiology, National & Kapodistrian University of Athens, Athens, Greece.

The Journal of International Medical Research
|July 31, 2024
PubMed

Insights

Elevated lipoprotein (a) [Lp(a)] is linked to cerebrovascular events like stroke in adults and children. New Lp(a)-targeting therapies show promise for stroke prevention.

Area of Science:

  • Cardiology
  • Neurology
  • Genetics

Background:

  • Lipoprotein (a) [Lp(a)] is structurally similar to LDL cholesterol.
  • Lp(a) is synthesized in the liver, with genetically determined plasma levels influenced by the LPA gene encoding apolipoprotein (a).

Purpose of the Study:

  • To comprehensively review the role of Lp(a) in cerebrovascular disease.
  • To examine the Lp(a)-cerebrovascular disease relationship from multiple perspectives.

Main Methods:

  • Narrative review of pertinent studies.
  • Analysis of epidemiological and Mendelian randomization data.
  • Inclusion of data on pediatric patients and emerging therapies.

Main Results:

  • Epidemiological studies show a positive correlation between high Lp(a) levels and cerebrovascular events, particularly ischemic strokes.
  • The correlation is noted to be marginal in Mendelian randomization studies.
  • Lp(a) appears significant in pediatric arterial ischemic stroke pathogenesis due to the absence of typical risk factors.

Conclusions:

  • New Lp(a)-targeting agents are in Phase 3 trials for stroke risk reduction.
  • Updated guidelines for Lp(a) screening and management are needed for effective primary and secondary stroke prevention.

Keywords:
Lipoprotein (a)atherosclerotic cardiovascular diseasecerebrovascular diseaseischemic strokelipoprotein (a) lowering agentpediatric stroke

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