Lipoprotein(a)
- 1 April 2016
- journal article
- review article
- Published by Ovid Technologies (Wolters Kluwer Health) in Current Opinion in Endocrinology, Diabetes and Obesity
- Vol. 23 (2), 157-164
- https://doi.org/10.1097/med.0000000000000237
Abstract
Purpose of review This article summarizes recent observations on the role of lipoprotein(a) [Lp(a)] as a risk factor mediating cardiovascular disease. Recent findings Lp(a) is a highly prevalent cardiovascular risk factor, with levels above 30 mg/dl affecting 20–30% of the global population. Up until now, no specific therapies have been developed to lower Lp(a) levels. Three major levels of evidence support the notion that elevated Lp(a) levels are a causal, independent, genetic risk factor for cardiovascular disease: epidemiologic studies and meta-analyses, genome-wide association studies and Mendelian randomization studies. Recent studies also have noted that individuals with low levels of Lp(a) are associated with a higher risk of incident type 2 diabetes mellitus, and conversely individuals with high levels have a lower risk, but this association does not appear to be causal. Novel therapies to lower Lp(a) include PCSK9 inhibitors and antisense oligonucleotides directly preventing translation of apolipoprotein(a) mRNA. Summary With this robust and expanding clinical database, a reawakening of interest in Lp(a) as clinical risk factor is taking place. Trials are underway with novel drugs that substantially lower Lp(a) and may reduce its contribution to cardiovascular disease.Keywords
This publication has 49 references indexed in Scilit:
- Large-scale association analysis identifies new risk loci for coronary artery diseaseNature Genetics, 2012
- Oxidized Phospholipids on apoB-100-Containing Lipoproteins: a Biomarker Predicting Cardiovascular Disease and Cardiovascular EventsBiomarkers in Medicine, 2011
- Genetic variants, plasma lipoprotein(a) levels, and risk of cardiovascular morbidity and mortality among two prospective cohorts of type 2 diabetesEuropean Heart Journal, 2011
- Single-Nucleotide Polymorphisms in LPA Explain Most of the Ancestry-Specific Variation in Lp(a) Levels in African AmericansPLOS ONE, 2011
- Lipoprotein(a) as a cardiovascular risk factor: current statusEuropean Heart Journal, 2010
- Lipoprotein(a) and Risk of Type 2 DiabetesClinical Chemistry, 2010
- Lipoprotein(a) Concentration and the Risk of Coronary Heart Disease, Stroke, and Nonvascular MortalityJAMA, 2009
- Genome-wide association study of plasma lipoprotein(a) levels identifies multiple genes on chromosome 6qJournal of Lipid Research, 2009
- Polymorphism in the apolipoprotein(a) gene, plasma lipoprotein(a), cardiovascular disease, and low-dose aspirin therapyAtherosclerosis, 2009
- Relationship of Oxidized Phospholipids on Apolipoprotein B-100 Particles to Race/Ethnicity, Apolipoprotein(a) Isoform Size, and Cardiovascular Risk FactorsCirculation, 2009