IMR Press / FBL / Volume 23 / Issue 6 / DOI: 10.2741/4635

Frontiers in Bioscience-Landmark (FBL) is published by IMR Press from Volume 26 Issue 5 (2021). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with Frontiers in Bioscience.

Open Access Review

Lipoprotein(a) and cardiovascular disease: current state and future directions for an enigmatic lipoprotein

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1 Section of Cardiovascular Research, Department of Medicine Baylor College of Medicine, USA
2 Health Policy, Quality and Informatics Program, Michael E. DeBakey Veterans Affairs Medical Center Health Services Research and Development Center for Innovations, Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, USA
3 Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart and Vascular Center, Houston, TX, USA
Front. Biosci. (Landmark Ed) 2018, 23(6), 1099–1112; https://doi.org/10.2741/4635
Published: 1 January 2018
Abstract

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.

Keywords
Cardiovascular Diseases
Coronary Heart Disease
Lipoprotein(a)
Lp(a)
apolipoprotein(a)
Review
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