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Lipoprotein(a) - From Biomarker to Therapy: A Review for the Clinician

Mawra Jha1, Inbar R McCarthy2, Eli V Gelfand1

  • 1Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.

The American Journal of Cardiology
|March 8, 2025
PubMed

Insights

Lipoprotein(a) [Lp(a)] is a key biomarker for cardiovascular disease risk. Emerging therapies targeting Lp(a) show promise in preventing and treating atherosclerotic cardiovascular disease and calcific aortic valve stenosis.

Area of Science:

  • Cardiology
  • Genetics
  • Biochemistry

Background:

  • Cardiovascular disease (CVD) is a leading global cause of death.
  • Lipoprotein(a) [Lp(a)] is an independent risk factor for atherosclerotic cardiovascular disease (ASCVD) and calcific aortic valve stenosis (AS).
  • Elevated Lp(a) levels, determined by genetics, contribute to vascular inflammation, atherogenesis, calcification, and thrombosis.

Purpose of the Study:

  • To review the current understanding of Lipoprotein(a) [Lp(a)].
  • To discuss Lp(a) as a biomarker for cardiovascular risk.
  • To explore Lp(a) as a therapeutic target for CVD prevention and treatment.

Main Methods:

  • Literature review of existing studies on Lp(a).
  • Analysis of Lp(a)'s biological functions and clinical implications.
  • Examination of emerging Lp(a)-lowering therapies.

Main Results:

  • Lp(a) is a significant, genetically determined risk factor for ASCVD and AS.
  • Antisense oligonucleotide (ASO) and small interfering ribonucleic acid (siRNA) therapies effectively reduce Lp(a) levels.
  • Ongoing clinical trials are evaluating the efficacy of these therapies in reducing CVD risk.

Conclusions:

  • Lp(a) is a critical biomarker and therapeutic target in cardiovascular medicine.
  • Lp(a)-lowering therapies represent a potential paradigm shift in CVD prevention.
  • Evolving guidelines and emerging treatments may transform clinical practice for managing CVD risk.

Keywords:
aortic valve stenosisatherosclerosiscardiovascular disease riskhyperlipidemialipidslipoprotein(A)therapeutic interventions

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