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SHR Neuro Krebs Kardio Lipid Stoffw Microb
Kostner, KM; März, W; Kostner, GM.
When should we measure lipoprotein (a)?
Eur Heart J. 2013; 34(42):3268-3276
Doi: 10.1093/eurheartj/eht053
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- Führende Autor*innen der Med Uni Graz
- März Winfried
- Co-Autor*innen der Med Uni Graz
- Kostner Gerhard
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- Abstract:
- Recently published epidemiological and genetic studies strongly suggest a causal relationship of elevated concentrations of lipoprotein (a) [Lp(a)] with cardiovascular disease (CVD), independent of low-density lipoproteins (LDLs), reduced high density lipoproteins (HDL), and other traditional CVD risk factors. The atherogenicity of Lp(a) at a molecular and cellular level is caused by interference with the fibrinolytic system, the affinity to secretory phospholipase A2, the interaction with extracellular matrix glycoproteins, and the binding to scavenger receptors on macrophages. Lipoprotein (a) plasma concentrations correlate significantly with the synthetic rate of apo(a) and recent studies demonstrate that apo(a) expression is inhibited by ligands for farnesoid X receptor. Numerous gaps in our knowledge on Lp(a) function, biosynthesis, and the site of catabolism still exist. Nevertheless, new classes of therapeutic agents that have a significant Lp(a)-lowering effect such as apoB antisense oligonucleotides, microsomal triglyceride transfer protein inhibitors, cholesterol ester transfer protein inhibitors, and PCSK-9 inhibitors are currently in trials. Consensus reports of scientific societies are still prudent in recommending the measurement of Lp(a) routinely for assessing CVD risk. This is mainly caused by the lack of definite intervention studies demonstrating that lowering Lp(a) reduces hard CVD endpoints, a lack of effective medications for lowering Lp(a), the highly variable Lp(a) concentrations among different ethnic groups and the challenges associated with Lp(a) measurement. Here, we present our view on when to measure Lp(a) and how to deal with elevated Lp(a) levels in moderate and high-risk individuals.
- Find related publications in this database (using NLM MeSH Indexing)
- Apoprotein(a) - chemistry
- Blood Specimen Collection - methods
- Cardiovascular Diseases - prevention & control
- Diabetes Mellitus - physiopathology
- Hormones - physiology
- Humans -
- Hypolipidemic Agents - pharmacology
- Kidney Failure, Chronic - physiopathology
- Lipoprotein(a) - chemistry
- Liver Diseases - physiopathology
- Practice Guidelines as Topic -
- Reference Values -
- Risk Assessment - methods
- Find related publications in this database (Keywords)
- Atherosclerosis
- Myocardial infarction
- Stroke
- Guidelines
- Assay