Lipoprotein(a) as a Stroke Biomarker: Pathophysiological Pathways and Therapeutic Implications

Area of Science:

• Cardiovascular Research
• Neurology
• Genetics

Background:

• Lipoprotein(a) [Lp(a)] is a genetically determined biomarker with stable plasma levels.
• Lp(a) possesses pro-atherogenic and pro-thrombotic properties impacting vascular pathology.
• Elevated Lp(a) is linked to large-artery atherosclerotic stroke, but its role in other stroke types is less clear.

Purpose of the Study:

• To review current evidence on Lp(a) and stroke association.
• To assess Lp(a) utility in patient risk stratification for cerebrovascular diseases.
• To highlight knowledge gaps and future research directions for Lp(a)-targeted therapies.

Main Methods:

• Narrative review of existing scientific literature.
• Analysis of Lp(a) association with different stroke subtypes.
• Evaluation of emerging Lp(a)-lowering therapies.

Main Results:

• Strong association between elevated Lp(a) and large-artery atherosclerotic stroke.
• Limited and inconsistent data on Lp(a)'s role in other ischemic and hemorrhagic stroke subtypes.
• Significant efficacy of novel therapies (ASOs, RNA-based agents) in reducing plasma Lp(a) levels.

Conclusions:

• Lp(a) holds potential for cerebrovascular disease risk stratification.
• Further research is needed to understand Lp(a)'s subtype-specific effects.
• Clinical trials evaluating Lp(a) reduction for stroke prevention are warranted.