The role of Lipoprotein(a) in cardiovascular disease: Current concepts and future perspectives

被引：15

作者：

Vavuranakis, Michael A. ^{[1
]}

Jones, Steven R. ^{[1
]}

Cardoso, Rhanderson ^{[2
]}

Gerstenblith, Gary ^{[1
]}

Leucker, Thorsten M. ^{[1
]}

机构：

[1] Johns Hopkins Univ, Sch Med, Dept Med, Div Cardiol, Baltimore, MD 21205 USA

[2] Harvard Med Sch, Brigham & Womens Hosp, Div Cardiol, Boston, MA 02115 USA

来源：

HELLENIC JOURNAL OF CARDIOLOGY | 2020年 / 61卷 / 06期

关键词：

Lipoprotein(a); Cardiovascular disease; OXIDIZED PHOSPHOLIPIDS; LP(A) LIPOPROTEIN; TARGETING APOLIPOPROTEIN(A); VALVE CALCIFICATION; DOUBLE-BLIND; RISK-FACTOR; PLASMA; INCREASES; PCSK9; ATHEROSCLEROSIS;

D O I：

10.1016/j.hjc.2020.09.016

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

High lipoprotein(a) [Lp(a)] levels are associated with the development of atherosclerotic cardiovascular disease (ASCVD) and with calcific aortic valve stenosis (CAVS) both observationally and causally from human genetic studies. The mechanisms are not well characterized but likely involve its role as a carrier of oxidized phospholipids (OxPLs), which are known to be increased in pro-inflammatory states, to induce pro-inflammatory changes in monocytes leading to plaque instability, and to impair vascular endothelial cell function, a driver of acute and recurrent ischemic events. In addition, Lp(a) itself has prothrombotic activity. Current lipid-lowering strategies do not sufficiently lower Lp(a) serum levels. Lp(a)-specific-lowering drugs, targeting apolipoprotein(a) synthesis, lower Lp(a) by up to 90% and are being evaluated in ongoing clinical outcome trials. This review summarizes the current knowledge on the associations of Lp(a) with ASCVD and CAVS, the current role of Lp(a) assessment in the clinical setting, and emerging Lp(a)-specific-lowering therapies. (C) 2020 Hellenic Society of Cardiology. Publishing services by Elsevier B.V.

引用

页码：398 / 403

页数：6

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