Is there a benefit of aspirin therapy for primary prevention to reduce the risk of atherosclerotic cardiovascular disease in patients with elevated Lipoprotein (a)-A review of the evidence

Mohamad Hekmat Sukkari; Basma Al-Bast; Raad Al Tamimi; William Giesing; Momin Siddique

doi:10.1016/j.ajpc.2023.100579

Is there a benefit of aspirin therapy for primary prevention to reduce the risk of atherosclerotic cardiovascular disease in patients with elevated Lipoprotein (a)-A review of the evidence

Am J Prev Cardiol. 2023 Sep 1:15:100579. doi: 10.1016/j.ajpc.2023.100579. eCollection 2023 Sep.

Authors

Mohamad Hekmat Sukkari¹, Basma Al-Bast², Raad Al Tamimi¹, William Giesing³, Momin Siddique²

Affiliations

¹ Internal Medicine, Southern Illinois University School of Medicine, Springfield, IL, USA.
² Cardiovascular Division, Southern Illinois University School of Medicine, Springfield, IL, USA.
³ Methodist Dallas Medical Center, Internal medicine, Dalles, TX, USA.

Abstract

Aspirin has long been recognized as a beneficial treatment for atherosclerotic cardiovascular disease (ASCVD) due to its antiplatelet effects. However, there is a need to more precisely identify individuals who would benefit from aspirin therapy for primary prevention in order to reduce the risk of ASCVD. Those with elevated lipoprotein (a) [Lp(a)] levels are at increased risk of ASCVD. In this article, we provide an overview of studies that have explored the use of aspirin therapy in individuals with elevated Lp(a). We discuss the potential mechanisms by which aspirin therapy may reduce ASCVD risk, and present a review of the data on the effectiveness of aspirin therapy in reducing ASCVD risk in individuals with elevated Lp(a). The presented evidence suggests that individuals with elevated Lp(a) benefit more from aspirin therapy for reduction of ASCVD events than the general population.

Keywords: Aspirin; Atherosclerotic cardiovascular disease; Cardiovascular risk; Coronary artery disease; Hyperlipidemia; Lipoprotein a.