Related Experiment Video
Updated: Jan 8, 2026
06:47
Isolation and Analysis of Plasma Lipoproteins by Ultracentrifugation
Published on: January 28, 2021
12.3K
Clinical Response to Elevated Lipoprotein(a): Practical Approach for Risk Management in the Absence of Targeted
Fabian Sanchis-Gomar1,2, Giuseppe Lippi3
1Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California.
Seminars in Thrombosis and Hemostasis
|December 11, 2025
Summary
Lipoprotein(a) (Lp(a)) is a key cardiovascular risk factor. While current treatments are limited, new RNA-based therapies show promise for significant Lp(a) reduction, with guidelines recommending Lp(a) testing.
Area of Science:
- Cardiovascular Medicine
- Genetics
- Pharmacology
Background:
- Lipoprotein(a) (Lp(a)) is a genetically determined risk factor for atherosclerotic cardiovascular disease (ASCVD).
- Optimal low-density lipoprotein cholesterol (LDL-C) lowering does not adequately address Lp(a)-driven risk.
- Current Lp(a)-specific therapies are limited, with statins, ezetimibe, and lifestyle changes having minimal impact.
Purpose of the Study:
- To review the current landscape of Lipoprotein(a) (Lp(a)) management.
- To highlight the limitations of existing therapies and the potential of emerging treatments.
- To emphasize the importance of Lp(a) measurement and risk stratification.
Main Methods:
- Literature review of current and emerging therapies for Lp(a).
- Analysis of guideline recommendations for Lp(a) testing and risk management.
- Evaluation of the efficacy of various interventions on Lp(a) levels.
Main Results:
- Statins and other lipid-lowering drugs have minimal effect on Lp(a).
- PCSK9 inhibitors and inclisiran offer modest Lp(a) reduction (20-30%) as a secondary effect.
- Lipoprotein apheresis effectively reduces Lp(a) (60-75%) but is invasive and costly.
- Emerging RNA-based therapies (antisense oligonucleotides, small interfering RNAs) demonstrate significant Lp(a) reduction (80-95%).
Conclusions:
- Despite limited current options, Lp(a)-targeted therapies are on the horizon.
- Guidelines recommend one-time Lp(a) measurement to identify at-risk individuals.
- Systematic screening and risk stratification are crucial for preparing patients for future Lp(a)-lowering treatments.
Related Concept Videos
01:26Atherosclerosis III: Management
293
Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
293
01:20Lipid-Lowering Drugs: Statins and Miscellaneous Agents
1.3K
Hyperlipidemia, a medical condition often referred to as high cholesterol, is characterized by abnormally elevated levels of lipids in the bloodstream. When present in excess, these lipids, specifically cholesterol and triglycerides, can lead to serious health complications, often involving cardiovascular diseases. Illnesses like atherosclerosis, heart attacks, and pancreatitis have all been linked to untreated hyperlipidemia. This means controlling and regulating cholesterol and triglyceride...
1.3K
01:26Coronary Artery Disease IV: Preventive Measures
572
Effective preventive measures for coronary artery disease (CAD) focus on controlling modifiable risk factors, including cholesterol abnormalities and lifestyle changes.Cholesterol ManagementFirst, the Mediterranean diet and the American Heart Association advocate for maintaining low-density lipoprotein (LDL) cholesterol levels below 100 mg/dL, with a more stringent recommendation of below 70 mg/dL for individuals at high risk. LDL cholesterol, often termed "bad cholesterol," can lead to the...
572
01:25Blood Studies for Cardiovascular System III: Serum Lipid Profile
534
Understanding serum lipids is crucial for maintaining cardiovascular health and preventing heart disease and stroke.
Serum lipids are fats and fatty substances in the blood and are crucial for various bodily functions, including energy storage, cellular structure, and hormone production. Serum lipids consist of cholesterol, triglycerides, and phospholipids.
Cholesterol is a soft, fat-like substance found in all body cells. It is crucial for producing hormones, vitamin D, and substances that aid...
Serum lipids are fats and fatty substances in the blood and are crucial for various bodily functions, including energy storage, cellular structure, and hormone production. Serum lipids consist of cholesterol, triglycerides, and phospholipids.
Cholesterol is a soft, fat-like substance found in all body cells. It is crucial for producing hormones, vitamin D, and substances that aid...
534
01:30Atherosclerosis I: Introduction
795
Atherosclerosis is a progressive disorder characterized by the buildup of plaques on the arterial inner wall, causing them to narrow and harden over time. These plaques comprise lipids, calcium, blood components, carbohydrates, and fibrous tissue. The process primarily affects the intima of large and medium-sized arteries, reducing blood flow in any artery.Etiology and risk factorsThe cause of atherosclerosis is multifactorial, involving a complex interplay among endothelial injury, lipid...
795
01:18Lipids: Dietary Sources and Requirements
1.8K
Lipids are an essential component of a balanced human diet. Triglycerides, which make up the majority of dietary lipids, are found in both saturated fats—commonly present in meat, dairy products, and certain tropical plants like coconut, and hydrogenated oils such as margarine and baking shortenings (trans fats)—and unsaturated fats, which are abundant in seeds, nuts, olive oil, and most vegetable oils. The main sources of cholesterol include egg yolks, various meats and organ...
1.8K