TY - JOUR
T1 - Lipoprotein(a) and cardiovascular disease
T2 - Current state and future directions for an enigmatic lipoprotein
AU - Saeed, Anum
AU - Virani, Salim S.
N1 - Funding Information:
Anum Saeed declares no disclosures or conflicts of interests. Salim S. Virani: Dr. Virani has received research support from the Department of Veterans Affairs, American Heart Association, and the American Diabetes Association. He also reports serving on the steering committee (with no financial remuneration) for the Patient and Provider Assessment of Lipid Management (PALM) Registry at the Duke Clinical Research Institute. He has received honorarium from the American College of Cardiology as Associate Editor for Innovations for ACC.org
Funding Information:
conflicts of interests. Salim S. Virani: Dr. Virani has received research support from the Department of Veterans Affairs, American Heart Association, and the American Diabetes Association. He also reports serving on the steering committee (with no financial remuneration) for the Patient and Provider Assessment of Lipid Management (PALM) Registry at the Duke Clinical Research Institute. He has received honorarium from the American College of Cardiology as Associate Editor for Innovations for ACC.org
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Lipoprotein (a) (Lp (a)) is a complex polymorphic lipoprotein. Although structurally similar to low-density lipoprotein, Lp(a) has a glycoprotein, apolipoprotein(a) (apo(a)), attached to the apolipoprotein B-100 component. Several unique properties of Lp(a) can be attributed to the presence of apo(a). Several decades of research has improved our understanding of the structure, biochemistry, and pathophysiology of Lp(a) associated diseases. Genetic, epidemiological, and translational data indicate that elevated Lp(a) levels are likely in the causal pathway for atherosclerotic cardiovascular diseases as well as calcification of the aortic valves. The "Lp(a) hypothesis," unlike the "LDL hypothesis," has not been tested in clinical trials yet. Currently, the management of elevated Lp(a) is directed at lowering low-density lipoprotein cholesterol levels. Developing therapies include antisense oligonucleotides which inhibit the synthesis of apo(a). This review discusses the current state of literature on pathophysiological and clinical aspects of Lp(a), including its role in coronary heart disease, stroke, aortic valve stenosis, and other vascular diseases. Current and emerging therapies aimed at treatment for elevated Lp(a) levels are also discussed.
AB - Lipoprotein (a) (Lp (a)) is a complex polymorphic lipoprotein. Although structurally similar to low-density lipoprotein, Lp(a) has a glycoprotein, apolipoprotein(a) (apo(a)), attached to the apolipoprotein B-100 component. Several unique properties of Lp(a) can be attributed to the presence of apo(a). Several decades of research has improved our understanding of the structure, biochemistry, and pathophysiology of Lp(a) associated diseases. Genetic, epidemiological, and translational data indicate that elevated Lp(a) levels are likely in the causal pathway for atherosclerotic cardiovascular diseases as well as calcification of the aortic valves. The "Lp(a) hypothesis," unlike the "LDL hypothesis," has not been tested in clinical trials yet. Currently, the management of elevated Lp(a) is directed at lowering low-density lipoprotein cholesterol levels. Developing therapies include antisense oligonucleotides which inhibit the synthesis of apo(a). This review discusses the current state of literature on pathophysiological and clinical aspects of Lp(a), including its role in coronary heart disease, stroke, aortic valve stenosis, and other vascular diseases. Current and emerging therapies aimed at treatment for elevated Lp(a) levels are also discussed.
KW - Apolipoprotein(a)
KW - Cardiovascular diseases
KW - Coronary heart disease
KW - Lipoprotein(a)
KW - Lp(a)
KW - Review
UR - http://www.scopus.com/inward/record.url?scp=85040447629&partnerID=8YFLogxK
U2 - 10.2741/4635
DO - 10.2741/4635
M3 - Review article
C2 - 28930591
AN - SCOPUS:85040447629
SN - 2768-6701
VL - 23
SP - 1099
EP - 1112
JO - Frontiers in Bioscience - Landmark
JF - Frontiers in Bioscience - Landmark
IS - 3
ER -
