The role of Lp(a) in cardiovascular diseases and treatment options

Harry May BS, Scott Shurmur, MD


Based on Centers for Disease Control and Prevention and World Health Organization statistics, cardiovascular disease (CVD) is the leading cause of death globally, especially in developed countries. Atherosclerosis, associated with inflammation and endothelial dysfunction, is one of the major causes of cardiovascular disease, and several studies have tried to identify risk factors for atherosclerosis. Lipoprotein (a) [Lp(a)] has become increasingly appreciated in the past decades as a strong independent risk factor. Although there are several clinical trials on lipid-lowering drugs to reduce the risk of CVD, most drugs not only fail to drop Lp(a) levels significantly but also do not specifically target Lp(a). While PCSK9 inhibitors are currently regarded as the best therapeutic drug for elevated Lp(a), recently, the development of novel drugs targeting the RNA of the Lp(a) gene (LPA), small interfering RNAs and antisense oligonucleotides, has progressed rapidly, and they have been assessed for their clinical efficacy. The objective of this case study/focused review is to review what Lp(a) is, why it has clinical significance in developing CVD, and more importantly how its level is controlled.

Keywords: Lipoprotein (a), cardiovascular diseases, atherosclerosis, PCSK9 inhibitors, antisense oligonucleotides, small interfering RNA.

Article citation: May H, Shurmur S. The role of Lp(a) in cardiovascular diseases and treatment options. The Southwest Respiratory and Critical Care Chronicles 2022;10(45):48–53
From: Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas
Submitted: 8/9/2022
Accepted: 10/8/2022
Conflicts of interest: none
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