Lipoprotein(a) in patients with breast cancer after chemotherapy: exploring potential strategies for cardioprotection

Lipids Health Dis. 2023 Sep 22;22(1):157. doi: 10.1186/s12944-023-01926-9.

Abstract

Developments in neoadjuvant and adjuvant chemotherapy (CHT) have led to an increase in the number of breast cancer survivors. The determination of an appropriate follow-up for these patients is of increasing importance. Deaths due to cardiovascular disease (CVD) are an important part of mortality in patients with breast cancer.This review suggests that chemotherapeutic agents may influence lipoprotein(a) (Lp(a)) concentrations in breast cancer survivors after CHT based on many convincing evidence from epidemiologic and observational researches. Usually, the higher the Lp(a) concentration, the higher the median risk of developing CVD. However, more clinical trial results are needed in the future to provide clear evidence of a possible causal relationship. This review also discuss the existing and emerging therapies for lowering Lp(a) concentrations in the clinical setting. Hormone replacement therapy, statins, proprotein convertase subtilisin/kexin-type 9 (PCSK9) inhibitors, Antisense oligonucleotides, small interfering RNA, etc. may reduce circulating Lp(a) or decrease the incidence of CVD.

Keywords: Cardiovascular disease; Lipoprotein(a); Measurements; PCSK9 inhibitors.

Publication types

  • Review

MeSH terms

  • Breast Neoplasms* / drug therapy
  • Cardiovascular Diseases* / drug therapy
  • Cardiovascular Diseases* / prevention & control
  • Female
  • Humans
  • Lipoprotein(a)
  • Proprotein Convertase 9

Substances

  • PCSK9 protein, human
  • Lipoprotein(a)
  • Proprotein Convertase 9