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Lp(a): A Clinical Review

Khalil Anchouche1, Alexis Baass2, George Thanassoulis1

  • 1McGill University Health Centre and Research Institute, Montreal, QC, Canada; McGill University, Montreal, QC, Canada.

Clinical Biochemistry
|April 21, 2025
PubMed

Insights

Elevated lipoprotein(a) (Lp[a]) is a key genetic risk factor for cardiovascular disease. New Lp[a]-lowering therapies are in late-stage trials, offering hope for future clinical practice.

Area of Science:

  • Cardiology
  • Genetics
  • Pharmacology

Background:

  • Elevated lipoprotein(a) (Lp[a]) is a prevalent, genetically determined risk factor for atherosclerotic cardiovascular disease and aortic stenosis.
  • Current guidelines recommend universal Lp[a] screening due to its significant impact on cardiovascular health.

Purpose of the Study:

  • To provide a comprehensive review of lipoprotein(a) (Lp[a]) biology, genetics, and clinical associations.
  • To highlight emerging Lp[a]-lowering therapies and their potential future clinical applications.

Main Methods:

  • Literature review of Lp(a) biology, genetics, and clinical associations.
  • Analysis of current drug development pipeline for Lp[a]-lowering agents.
  • Discussion of the potential role of novel therapies in clinical practice.

Main Results:

  • Lp(a) is a significant, inherited risk factor for cardiovascular diseases, including atherosclerotic cardiovascular disease and aortic stenosis.
  • Several novel therapies targeting Lp[a) reduction are in late-stage clinical trials.
  • These therapies hold promise for future management of cardiovascular risk associated with elevated Lp(a).

Conclusions:

  • Universal screening for Lp(a) is increasingly recommended for cardiovascular risk assessment.
  • Emerging Lp(a)-lowering therapies represent a significant advancement in managing this risk factor.
  • These novel treatments are expected to play a crucial role in future cardiovascular medicine.

Keywords:
Antisense oligonucleotides (ASO)Aortic stenosisCardiovascular geneticsLipoprotein(a) (Lp[a])Myocardial infarctionSmall interfering RNA (siRNA)

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