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News & Press: Clinical News

Lipoprotein(a) in Cardiovascular Diseases

Friday, September 13, 2013   (0 Comments)
Posted by: Sandra Tremulis
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The clinical interest in Lp(a) is largely derived from its role as a cardiovascular risk factor. Although not considered an established risk factor, Lp(a) levels have been associated with cardiovascular disease in numerous studies [72, 104, 105]. Recently Lp(a) serum levels were found to be associated with the severity of aortic atherosclerosis, especially in abdominal aorta, as well as coronary atherosclerosis [106]. Moreover a study by Momiyama et al. [107] demonstrated that elevated Lp(a) has incremental prognostic value in symptomatic patients with coronary artery revascularization [108]. Lp(a) is involved in the development of atherothrombosis and activation of acute inflammation exerting a proatherogenic and hypofibrinolytic effect. Lp(a) plays a critical role in the proinflammatory reaction and can be considered as a common joint among different metabolic systems. Other actions of Lp(a) can be resumed as follows: inhibition of the activation of plasminogen; inhibition of the activation of TGF-β; activation of acute inflammation; induction of the expression of adhesion molecules; elevation of the production of cytokines. Moreover Lp(a) is implicated in the activation of endothelial uptake, oxidative modification, and foam cell formation, suggesting that these processes could play an important role in atherosclerosis. Recent findings suggest that Lp(a)-lowering therapy might be beneficial, at least in some subgroups of patients with high Lp(a) levels. A possible future therapeutic approach could include apheresis in high-risk patients with already maximally reduced LDL cholesterol levels in order to reduce major coronary events [72]. However, further studies are needed to define such subgroups with regard to Lp(a) levels, apo(a) size, and the presence of other risk factors.

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