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[Lipoprotein (a), a cardiovascular risk factor: importance of its determination in current clinical practice]

R Couderc1, M Maachi

  • 1Laboratoire de Biochimie, Hôpital Tenon, Paris.

Insights

High levels of Lipoprotein (a) [Lp(a)] significantly increase the risk of atherosclerosis. Measuring Lp(a) is crucial for assessing cardiovascular and cerebrovascular disease risk, especially in high-risk patients.

Area of Science:

  • Cardiovascular Biology
  • Lipid Metabolism
  • Thrombosis Research

Context:

  • Lipoprotein (a) [Lp(a)] is an LDL-like particle with thrombogenic and atherogenic properties due to its apo-lipoprotein (a) component, which shares homology with plasminogen.
  • Epidemiological evidence strongly links elevated plasma Lp(a) levels to increased risk of coronary, cerebral, and peripheral atherosclerosis.

Purpose:

  • To review the existing literature on the relationship between Lipoprotein (a) and atherosclerosis.
  • To highlight the clinical significance of Lp(a) measurement in cardiovascular risk assessment.

Summary:

  • Multiple prospective studies confirm that high Lp(a) is a significant risk factor for atherosclerosis.
  • Discrepancies in some studies are attributed to sample handling or patient medication.
  • Lp(a) possesses both atherogenic and thrombogenic capacities, contributing to vascular disease development.

Impact:

  • Measuring Lp(a) is essential for a more accurate evaluation of atherosclerotic vascular disease risk.
  • This is particularly important for patients with hyper LDLemia, a history of early cardio- or cerebrovascular events, or a family history of atherosclerosis.
  • Understanding Lp(a)'s role can lead to improved patient stratification and personalized preventive strategies.

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