Screening for and management of elevated Lp(a).
While lipoprotein(a) (Lp(a)) has long been an intriguing subject for basic researchers and clinicians alike, it is only recently that this unique cardiovascular risk factor has begun to be broadly utilized as part of risk prediction. This has dovetailed with the recognition, from genetic studies, that Lp(a) is indeed causal for atherothrombotic disease rather than being merely a marker. Yet, significant questions remain the subject of ongoing study including: what patients groups benefit the most from determination of plasma Lp(a) concentrations; how can elevated plasma Lp(a) concentrations be most effectively managed; does reduction in plasma Lp(a) concentrations reduce risk for atherothrombotic events; and what is the molecular mechanism or mechanisms underlying the risk attributed to elevated Lp(a)? This review summarizes recent progress in genetic studies, basic laboratory research, and epidemiology with a focus on how Lp(a) might be incorporated into clinical practice.
Department of Chemistry & Biochemistry, University of Windsor, 401 Sunset Avenue, Windsor, Ontario, Canada, mboffa@uwindsor.ca.
Michael B
MB
Boffa
Marlys L
ML
Koschinsky
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D001241:Aspirin / Q000627:therapeutic use; D050197:Atherosclerosis / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D002170:Canada / Q000453:epidemiology; D005260:Female; D006801:Humans; D017270:Lipoprotein(a) / Q000097:blood* / Q000235:genetics; D008297:Male; D008403:Mass Screening; D009841:Oligonucleotides / Q000627:therapeutic use; D023303:Oxazolidinones / Q000627:therapeutic use; D011237:Predictive Value of Tests; D012307:Risk Factors
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000924:Anticholesteremic Agents; D015415:Biomarkers; D017270:Lipoprotein(a); D009841:Oligonucleotides; D023303:Oxazolidinones; C524142:mipomersen; C530884:anacetrapib; D001241:Aspirin