Lipoprotein(a)-clinical aspects and future challenges

Clinical Research in Cardiology Supplements
Bilgen KurtJuergen R Schaefer

Abstract

Lipoprotein(a) (Lp(a)) was first described by K. Berg and is known for more than 50 years. It is an interesting particle and combines the atherogenic properties of low-density lipoprotein (LDL)-cholesterol as well as the thrombogenic properties of plasminogen inactivation. However, due to technical problems and publication of negative trials the potential role of Lp(a) in atherosclerosis was severely underestimated. In recent years our understanding of the function and importance of Lp(a) improved. Interventional trials with niacin failed to demonstrate any benefit of lowering Lp(a); however, several studies confirmed the residual cardiovascular disease (CVD) risk of elevated Lp(a). LDL/Lp(a) apheresis is able to lower Lp(a) and some new drugs under development should help us to lower Lp(a) in the near future. It will be important to follow this with hard endpoint trials. Until then most clinicians recommend the use of an aggressive LDL-lowering approach in patients with high Lp(a). Since most of these patients with high Lp(a) might have manifested atherosclerosis anyway, we would also consider the use of acetylsalicylic acid.

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Citations

Jun 21, 2016·Journal of Clinical Apheresis
Oct 30, 2016·The American Journal of Cardiology·Daniel GaudetFrederick J Raal
Aug 23, 2017·Journal of Cardiovascular Pharmacology and Therapeutics·Theodosios D FilippatosMoses S Elisaf
Jul 5, 2016·Journal of Physiology and Biochemistry·Paloma CeladaBegoña Olmedilla-Alonso
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Aug 28, 2019·Current Medicinal Chemistry·Olga PanagiotopoulouMarietta Charakida
Jul 17, 2019·Clinical Therapeutics·Heitor O SantosRodrigo C O Macedo
Nov 5, 2019·Thrombosis Research·Ida GregersenPer Morten Sandset

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Methods Mentioned

BETA
PROCARDIS
genotyping
electrophoresis
antisense oligonucleotides
transgenic

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