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A Test in Context: Lipoprotein(a): Diagnosis, Prognosis, Controversies, and Emerging Therapies

Journal of the American College of Cardiology, 2017-02, Vol.69 (6), p.692-711 [Peer Reviewed Journal]

Copyright © 2017 The Author. Published by Elsevier Inc. All rights reserved. ;Copyright Elsevier Limited Feb 14, 2017 ;ISSN: 0735-1097 ;EISSN: 1558-3597 ;DOI: 10.1016/j.jacc.2016.11.042 ;PMID: 28183512

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  • Title:
    A Test in Context: Lipoprotein(a): Diagnosis, Prognosis, Controversies, and Emerging Therapies
  • Author: Tsimikas, Sotirios
  • Subjects: Apolipoproteins ; Binding sites ; Cardiovascular Diseases - diagnosis ; Cardiovascular Diseases - epidemiology ; Cardiovascular Diseases - therapy ; Chemical bonds ; Cholesterol ; Humans ; Lipids ; Lipoprotein(a) - physiology ; Low density lipoprotein ; Plasma ; Prognosis ; Risk Factors ; Rodents
  • Is Part Of: Journal of the American College of Cardiology, 2017-02, Vol.69 (6), p.692-711
  • Description: Evidence that elevated lipoprotein(a) (Lp[a]) levels contribute to cardiovascular disease (CVD) and calcific aortic valve stenosis (CAVS) is substantial. Development of isoform-independent assays, in concert with genetic, epidemiological, translational, and pathophysiological insights, have established Lp(a) as an independent, genetic, and likely causal risk factor for CVD and CAVS. These observations are consistent across a broad spectrum of patients, risk factors, and concomitant therapies, including patients with low-density lipoprotein cholesterol <70 mg/dl. Statins tend to increase Lp(a) levels, possibly contributing to the "residual risk" noted in outcomes trials and at the bedside. Recently approved proprotein convertase subtilisin/kexin-type 9 inhibitors and mipomersen lower Lp(a) 20% to 30%, and emerging RNA-targeted therapies lower Lp(a) >80%. These approaches will allow testing of the "Lp(a) hypothesis" in clinical trials. This review summarizes the current landscape of Lp(a), discusses controversies, and reviews emerging therapies to reduce plasma Lp(a) levels to decrease risk of CVD and CAVS.
  • Publisher: United States: Elsevier Limited
  • Language: English
  • Identifier: ISSN: 0735-1097
    EISSN: 1558-3597
    DOI: 10.1016/j.jacc.2016.11.042
    PMID: 28183512
  • Source: Geneva Foundation Free Medical Journals at publisher websites
    MEDLINE
    Alma/SFX Local Collection
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