Lipoprotein(a)--An independent causal risk factor for cardiovascular disease and current therapeutic options.
It is widely accepted that elevated levels of lipoprotein(a) (Lp(a)) are associated with an increased risk for cardiovascular diseases. Several studies have identified Lp(a) as independent cardiovascular risk factor. Consequently, therapeutic concepts are targeting at lowering Lp(a) serum levels. To date, in Europe no pharmaceutical treatment to lower levels of Lp(a) is available. Current developments of pharmaceutical agents like the apolipoprotein-(B-100)-antisense mipomersen, inhibitors of PCSK9 and apolipoprotein-(a)-antisense have shown promising results in lowering Lp(a). Presently, the only available therapy to effectively reduce levels of Lp(a) is regular extracorporeal lipoprotein apheresis. Different apheresis methods show a similar lowering effect of about 60-70 % by a single session. Apart from one small-scale study there has been no randomized, controlled study which could prove that lowering Lp(a) will result in a risk reduction for cardiovascular disease. This review looks into the current scientific evidence of.
Outpatient Clinic for Lipid Metabolism Disorders, Interdisciplinary Metabolism Center, Charité - Universitaetsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany. Electronic address: ursula.kassner@charite.de.
Ursula
U
Kassner
Outpatient Clinic for Lipid Metabolism Disorders, Interdisciplinary Metabolism Center, Charité - Universitaetsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany; Medical Department, Division of Cardiology, CharitéCenter 11 for Cardiovascular Diseases, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany.
Thomas
T
Schlabs
Outpatient Clinic for Lipid Metabolism Disorders, Interdisciplinary Metabolism Center, Charité - Universitaetsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany; Medical Department of Geriatrics, Evangelisches Geriatriezentrum Berlin, Reinickendorfer Straße 61, 13347 Berlin, Germany.
Adrian
A
Rosada
Outpatient Clinic for Lipid Metabolism Disorders, Interdisciplinary Metabolism Center, Charité - Universitaetsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany; Medical Department of Geriatrics, Evangelisches Geriatriezentrum Berlin, Reinickendorfer Straße 61, 13347 Berlin, Germany.
Elisabeth
E
Steinhagen-Thiessen
D015415:Biomarkers / Q000097:blood; D001781:Blood Component Removal / Q000379:methods*; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D006951:Hyperlipoproteinemias / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D017270:Lipoprotein(a) / Q000097:blood*; D012307:Risk Factors; D016896:Treatment Outcome
D015415:Biomarkers; D000960:Hypolipidemic Agents; D017270:Lipoprotein(a)
Cardiovascular disease; Lipoprotein apheresis; Lipoprotein(a)