Role of Lipoprotein(a) Reduction in Cardiovascular Disease

Overview

Journal J Clin Med

Specialty General Medicine

Date 2024 Nov 9

PMID 39518451

Authors

Uma Schuth

Kieran Gill

Pyotr Telyuk

Bilal-Reshad Bawamia

David Austin

Azfar Zaman

Affiliations

Soon will be listed here.

Abstract

Recent studies have shown that lipoprotein(a) (Lp(a)) is an important risk factor for a plethora of different cardiovascular diseases. It has been proven that Lp(a) levels are genetically determined and correlate with risk of cardiovascular disease, independent of lifestyle factors. As of yet, treatment options to reduce Lp(a) levels are limited, but new research into Lp(a) reduction yields promising results. This review delves into Lp(a)'s biochemistry and mechanism of effect, the association between Lp(a) and cardiovascular diseases, and possible therapies to minimise cardiovascular disease.

References

Eaton D, Fless G, Kohr W, McLean J, Xu Q, Miller C . Partial amino acid sequence of apolipoprotein(a) shows that it is homologous to plasminogen. Proc Natl Acad Sci U S A. 1987; 84(10):3224-8. PMC: 304841. DOI: 10.1073/pnas.84.10.3224. View

Tsimikas S, Fazio S, Viney N, Xia S, Witztum J, Marcovina S . Relationship of lipoprotein(a) molar concentrations and mass according to lipoprotein(a) thresholds and apolipoprotein(a) isoform size. J Clin Lipidol. 2018; 12(5):1313-1323. DOI: 10.1016/j.jacl.2018.07.003. View

Kaltoft M, Sigvardsen P, Afzal S, Langsted A, Fuchs A, Kuhl J . Elevated lipoprotein(a) in mitral and aortic valve calcification and disease: The Copenhagen General Population Study. Atherosclerosis. 2021; 349:166-174. DOI: 10.1016/j.atherosclerosis.2021.11.029. View

Scheen A, Wallemacq C, Lancellotti P . [Inclisiran (Leqvio®), a potent cholesterol-lowering agent by inhibiting PCSK9 using small interfering RNA-based innovative therapy]. Rev Med Liege. 2022; 77(12):745-751. View

Wang X, Li J, Ju J, Fan Y, Xu H . Effect of different types and dosages of statins on plasma lipoprotein(a) levels: A network meta-analysis. Pharmacol Res. 2020; 163:105275. DOI: 10.1016/j.phrs.2020.105275. View

Kronenberg F . Lipoprotein(a): from Causality to Treatment. Curr Atheroscler Rep. 2024; 26(3):75-82. PMC: 10881767. DOI: 10.1007/s11883-024-01187-6. View

Guddeti R, Patil S, Ahmed A, Sharma A, Aboeata A, Lavie C . Lipoprotein(a) and calcific aortic valve stenosis: A systematic review. Prog Cardiovasc Dis. 2020; 63(4):496-502. DOI: 10.1016/j.pcad.2020.06.002. View

Willeit P, Ridker P, Nestel P, Simes J, Tonkin A, Pedersen T . Baseline and on-statin treatment lipoprotein(a) levels for prediction of cardiovascular events: individual patient-data meta-analysis of statin outcome trials. Lancet. 2018; 392(10155):1311-1320. DOI: 10.1016/S0140-6736(18)31652-0. View

Kraft H, Lingenhel A, Kochl S, Hoppichler F, Kronenberg F, Abe A . Apolipoprotein(a) kringle IV repeat number predicts risk for coronary heart disease. Arterioscler Thromb Vasc Biol. 1996; 16(6):713-9. DOI: 10.1161/01.atv.16.6.713. View

10.

Enkhmaa B, Anuurad E, Berglund L . Lipoprotein (a): impact by ethnicity and environmental and medical conditions. J Lipid Res. 2015; 57(7):1111-25. PMC: 4918859. DOI: 10.1194/jlr.R051904. View

11.

Hardy J, Niman S, Goldfaden R, Ashchi M, Bisharat M, Huston J . A Review of the Clinical Pharmacology of Pelacarsen: A Lipoprotein(a)-Lowering Agent. Am J Cardiovasc Drugs. 2021; 22(1):47-54. DOI: 10.1007/s40256-021-00499-1. View

12.

Erqou S, Thompson A, Di Angelantonio E, Saleheen D, Kaptoge S, Marcovina S . Apolipoprotein(a) isoforms and the risk of vascular disease: systematic review of 40 studies involving 58,000 participants. J Am Coll Cardiol. 2010; 55(19):2160-7. DOI: 10.1016/j.jacc.2009.10.080. View

13.

Visseren F, Mach F, Smulders Y, Carballo D, Koskinas K, Back M . 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J. 2021; 42(34):3227-3337. DOI: 10.1093/eurheartj/ehab484. View

14.

Kamstrup P, Tybjaerg-Hansen A, Nordestgaard B . Genetic evidence that lipoprotein(a) associates with atherosclerotic stenosis rather than venous thrombosis. Arterioscler Thromb Vasc Biol. 2012; 32(7):1732-41. DOI: 10.1161/ATVBAHA.112.248765. View

15.

Lackner C, Cohen J, Hobbs H . Molecular definition of the extreme size polymorphism in apolipoprotein(a). Hum Mol Genet. 1993; 2(7):933-40. DOI: 10.1093/hmg/2.7.933. View

16.

Guyton J, Blazing M, Hagar J, Kashyap M, Knopp R, McKenney J . Extended-release niacin vs gemfibrozil for the treatment of low levels of high-density lipoprotein cholesterol. Niaspan-Gemfibrozil Study Group. Arch Intern Med. 2000; 160(8):1177-84. DOI: 10.1001/archinte.160.8.1177. View

17.

Kamstrup P, Benn M, Tybjaerg-Hansen A, Nordestgaard B . Extreme lipoprotein(a) levels and risk of myocardial infarction in the general population: the Copenhagen City Heart Study. Circulation. 2007; 117(2):176-84. DOI: 10.1161/CIRCULATIONAHA.107.715698. View

18.

Wilson D, Jacobson T, Jones P, Koschinsky M, McNeal C, Nordestgaard B . Use of Lipoprotein(a) in clinical practice: A biomarker whose time has come. A scientific statement from the National Lipid Association. J Clin Lipidol. 2022; 16(5):e77-e95. DOI: 10.1016/j.jacl.2022.08.007. View

19.

Enkhmaa B, Berglund L . Statins and Lp(a): The plot thickens. Atherosclerosis. 2019; 289:173-175. PMC: 7098730. DOI: 10.1016/j.atherosclerosis.2019.07.021. View

20.

Utermann G . The mysteries of lipoprotein(a). Science. 1989; 246(4932):904-10. DOI: 10.1126/science.2530631. View