Lipoprotein(a) in clinical practice: A guide for the clinician

Prog Cardiovasc Dis. 2023 Jul-Aug:79:28-36. doi: 10.1016/j.pcad.2023.07.006. Epub 2023 Jul 27.

Abstract

Cardiovascular disease (CVD) remains the leading cause of death worldwide. Serum lipoprotein(a) (Lp(a)) has been shown to be an independent and causative risk factor for atherosclerotic CVD and calcific aortic valvular disease. Lp(a) continues to be studied, with emerging insights into the epidemiology of CVD with respect to Lp(a), pathogenic mechanisms of Lp(a) and strategies to mitigate disease. There have been novel insights into genetic polymorphisms of the LPA gene, interactions between concomitant risk factors and Lp(a) based on real-world data, and metabolic pathway targets for Lp(a) reduction. This review highlights these recent advances in our understanding of Lp(a) and discusses management strategies as recommended by cardiovascular professional societies, emerging therapies for lowering Lp(a), and future directions in targeting Lp(a) to reduce CVD.

Keywords: Atherosclerosis; Calcific aortic stenosis; Coronary artery disease; Dyslipidemia; Genetics; Lipoprotein(a); Pathophysiology; Risk factors.

Publication types

  • Review

MeSH terms

  • Aortic Valve / pathology
  • Aortic Valve Stenosis* / epidemiology
  • Atherosclerosis* / diagnosis
  • Atherosclerosis* / epidemiology
  • Atherosclerosis* / genetics
  • Cardiovascular Diseases* / diagnosis
  • Cardiovascular Diseases* / epidemiology
  • Cardiovascular Diseases* / genetics
  • Humans
  • Lipoprotein(a) / genetics
  • Risk Factors

Substances

  • Lipoprotein(a)