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Interaction Between Lipoprotein(a) and Other Lipid Molecules: A Review of the Current Literature

Hesham Sheashaa1, Hana Mousa1, Mohammed Tiseer Abbas1

  • 1Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USA.

Biomolecules
|February 26, 2025
PubMed

Insights

Lipoprotein(a) [Lp(a)] is a key driver of cardiovascular disease (CVD). This review examines how Lp(a) interacts with LDL cholesterol and other lipids, impacting CVD risk and treatment strategies.

Area of Science:

  • Cardiology
  • Lipidology
  • Genetics

Background:

  • Lipoprotein(a) [Lp(a)] is a confirmed causal risk factor for cardiovascular diseases (CVDs).
  • Elevated Lp(a) combined with high LDL cholesterol (LDL-C) exhibits a synergistic atherogenic effect.
  • Conflicting data exist on Lp(a)'s role with controlled LDL-C levels and the impact of LDL-C reduction on Lp(a)-mediated atherogenesis.

Purpose of the Study:

  • To review current evidence on Lp(a) interactions with other lipids in CVD pathogenesis.
  • To clarify the impact of controlled LDL-C on Lp(a)'s atherogenic effect.
  • To discuss future perspectives, including emerging Lp(a)-lowering therapies.

Main Methods:

  • Literature review of epidemiological and Mendelian randomization studies.
  • Synthesis of evidence on Lp(a) interactions with LDL-C, triglycerides, HDL, and VLDL.
  • Analysis of studies investigating Lp(a) in the context of varying LDL-C levels.

Main Results:

  • Some studies show elevated Lp(a) increases CVD risk even with controlled LDL-C.
  • Other studies report reduced Lp(a)-mediated CVD risk when LDL-C is lowered.
  • The relationship between Lp(a) and triglycerides, HDL, and VLDL remains incompletely understood.

Conclusions:

  • Lp(a) remains a significant CVD risk factor, with complex interactions with other lipids.
  • Further research is needed to fully elucidate these interactions and optimize therapeutic strategies.
  • Development of targeted Lp(a)-lowering therapies offers new avenues for CVD risk management.

Keywords:
atherosclerosiscardiovascularinteractionlipoprotein(a)mortalityrisk factor

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