Lipoprotein(a) and Atherosclerotic Cardiovascular Disease, the Impact of Available Lipid-Lowering Medications on Lipoprotein(a): An Update on New Therapies

被引:4
作者
Tsushima, Takahiro [1 ]
Tsushima, Yumiko [2 ]
Sullivan, Claire [1 ]
Hatipoglu, Betul [2 ,3 ,4 ,5 ,6 ]
机构
[1] Case Western Reserve Univ, Univ Hosp Harrington Heart & Vasc Inst, Dept Med, Div Cardiol,Sch Med, Cleveland, OH 44106 USA
[2] Case Western Reserve Univ, Univ Hosp Cleveland Med Ctr, Diabet & Obes Ctr, Dept Med,Sch Med, Cleveland, OH 44106 USA
[3] Case Western Reserve Univ, Med, Sch Med, 11100 Euclid Ave, Cleveland, OH 44106 USA
[4] Univ Hosp Syst Clin Affair, 11100 Euclid Ave, Cleveland, OH 44106 USA
[5] Univ Hosp Cleveland Med Ctr, Diabet & Obes Ctr, 11100 Euclid Ave Cleveland, Cleveland, OH 44106 USA
[6] Univ Hosp Cleveland Med Ctr, Adult Endocrinol, 11100 Euclid Ave, Cleveland, OH 44106 USA
关键词
lipoprotein(a); lipoproteinemia; hyperlipoproteinemia; atherosclerotic cardiovascular disease; EXTENDED-RELEASE NIACIN; LOW-DENSITY-LIPOPROTEIN; CHOLESTEROL ABSORPTION INHIBITOR; DOUBLE-BLIND; PRIMARY HYPERCHOLESTEROLEMIA; PLASMA LIPOPROTEIN(A); FOLLOW-UP; FAMILIAL HYPERCHOLESTEROLEMIA; TARGETING APOLIPOPROTEIN(A); OXIDIZED PHOSPHOLIPIDS;
D O I
10.1016/j.eprac.2022.12.011
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: To review evidence of existing and new pharmacological therapies for lowering lipoprotein(a) (Lp[a]) concentrations and their impact on clinically relevant outcomes. Methods: We searched for literature pertaining to Lp(a) and pharmacological treatments in PubMed. We reviewed articles published between 1963 and 2020. Results: We found that statins significantly increased Lp(a) concentrations. Therapies that demonstrated varying degrees of Lp(a) reduction included ezetimibe, niacin, proprotein convertase subtilisin/kexin type 9 inhibitors, lipoprotein apheresis, fibrates, aspirin, hormone replacement therapy, antisense oligonucleotide therapy, and small interfering RNA therapy. There was limited data from large observational studies and post hoc analyses showing the potential benefits of these therapies in improving cardiovascular outcomes.Conclusion: There are multiple lipid-lowering agents currently being used to treat hyperlipidemia that also have a Lp(a)-lowering effect. Two RNA therapies specifically targeted to lower Lp(a) are being investigated in phase 3 clinical trials and, thus far, have shown promising results. However, evidence is lacking to determine the clinical relevance of reducing Lp(a). At present, there is a need for large-scale, randomized, controlled trials to evaluate cardiovascular outcomes associated with lowering Lp(a).
引用
收藏
页码:491 / 497
页数:7
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