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Clinical Research in Cardiology Supplements

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Open Access 01-04-2015

Lipoprotein(a)—clinical aspects and future challenges

Authors: Bilgen Kurt, Muhidien Soufi, Alexander Sattler, Juergen R. Schaefer

Published in: Clinical Research in Cardiology Supplements | Special Issue 1/2015

Abstract

Lipoprotein(a) (Lp(a)) was first described by K. Berg and is known for more than 50 years. It is an interesting particle and combines the atherogenic properties of low-density lipoprotein (LDL)-cholesterol as well as the thrombogenic properties of plasminogen inactivation. However, due to technical problems and publication of negative trials the potential role of Lp(a) in atherosclerosis was severely underestimated. In recent years our understanding of the function and importance of Lp(a) improved. Interventional trials with niacin failed to demonstrate any benefit of lowering Lp(a); however, several studies confirmed the residual cardiovascular disease (CVD) risk of elevated Lp(a). LDL/Lp(a) apheresis is able to lower Lp(a) and some new drugs under development should help us to lower Lp(a) in the near future. It will be important to follow this with hard endpoint trials. Until then most clinicians recommend the use of an aggressive LDL-lowering approach in patients with high Lp(a). Since most of these patients with high Lp(a) might have manifested atherosclerosis anyway, we would also consider the use of acetylsalicylic acid.

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Title: Lipoprotein(a)—clinical aspects and future challenges
Authors: Bilgen Kurt
Muhidien Soufi
Alexander Sattler
Juergen R. Schaefer
Publication date: 01-04-2015
Publisher: Springer Berlin Heidelberg
Published in: Clinical Research in Cardiology Supplements / Issue Special Issue 1/2015
Print ISSN: 1861-0706
Electronic ISSN: 1861-0714
DOI: https://doi.org/10.1007/s11789-015-0075-z

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