title: Evidence-based assessment of lipoprotein(a) as a risk biomarker for cardiovascular diseases - Some answers and still many questions.
abstract: The present article is aimed at outlining the current state of knowledge regarding the clinical value of lipoprotein(a) (Lp(a)) as a marker of cardiovascular disease (CVD) risk by summarizing the results of recent clinical studies, meta-analyses and systematic reviews. The literature supports the predictive value of Lp(a) on CVD outcomes, although the effect size is modest. Lp(a) would also appear to have an effect on cerebrovascular outcomes, however the effect appears even smaller than that for CVD outcomes. Consideration of apolipoprotein(a) (apo(a)) isoforms and LPA genetics in relation to the simple assessment of Lp(a) concentration may enhance clinical practice in vascular medicine. We also describe recent advances in Lp(a) research (including therapies) and highlight areas where further research is needed such as the measurement of Lp(a) and its involvement in additional pathophysiological processes.
authors.affiliation: a Division of Community and Family MedicinevJichi Medical University , Shimotsuke-City , Japan .|b Department of Clinical Laboratory Medicine , Jichi Medical University , Shimotsuke-City , Japan .
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Kotani
authors.affiliation: c Department of Epidemiology , University of Alabama at Birmingham , Birmingham , AL , USA .|d Department of Functional Sciences , Discipline of Pathophysiology, "Victor Babes" University of Medicine and Pharmacy , Timisoara , Romania .
authors.forename: Maria-Corina
authors.initials: MC
authors.lastname: Serban
authors.affiliation: e Section of Clinical Biochemistry , School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University , Liverpool , UK .
authors.forename: Peter
authors.initials: P
authors.lastname: Penson
authors.affiliation: f Section of Clinical Biochemistry , University of Verona , Verona , Italy , and.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lippi
authors.affiliation: g Department of Hypertension , Chair of Nephrology and Hypertension, Medical University of Lodz , Lodz , Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Banach
mesh_terms: D015415:Biomarkers / Q000097:blood*; D002318:Cardiovascular Diseases / Q000097:blood* / Q000453:epidemiology*; D019317:Evidence-Based Medicine; D006801:Humans; D017270:Lipoprotein(a) / Q000097:blood*
chemical_list: D015415:Biomarkers; D017270:Lipoprotein(a)
keywords: Apo(a); LPA; Lp(a); cardiovascular disease; cerebrovascular disease; coronary heart disease; stroke