Lipoprotein(a) and peripheral artery disease: contemporary evidence and therapeutic advances.

IF 4.6 3区医学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY

Current opinion in lipidology Pub Date : 2025-10-01 Epub Date: 2025-05-21 DOI:10.1097/MOL.0000000000000998

Shivshankar Thanigaimani, Maarisha Kumar, Jonathan Golledge

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引用次数: 0

Abstract

Purpose of review: Peripheral artery disease (PAD) is a major cause of global health burden, including amputation and impaired quality of life. This review examines the evidence implicating lipoprotein(a) [Lp(a)] in PAD, which is timely as novel therapies lowering Lp(a) are currently being tested in several clinical trials.

Recent findings: Human observational studies demonstrate strong associations between elevated Lp(a) levels and increased risk of PAD incidence, severity of chronic limb-threatening ischemia, and major adverse limb events. Emerging therapies including small interfering RNA, antisense oligonucleotides, proprotein convertase subtilisin-kexin type 9 inhibitors and lipoprotein apheresis demonstrate significant Lp(a)-lowering effects. However, whether these treatments benefit patients with PAD is currently unknown.

Summary: Lp(a) may be involved in PAD pathogenesis. Lp(a)-lowering therapies may significantly reduce PAD-related events and improve outcomes. Future studies are needed to test Lp(a)-lowering therapies in people with PAD and to explore how the association of Lp(a) varies in different sexes and ethnicities and understand mechanisms by which Lp(a) may contribute to limb ischemia.

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脂蛋白(a)和外周动脉疾病：当代证据和治疗进展

综述目的：外周动脉疾病（PAD）是全球健康负担的主要原因，包括截肢和生活质量受损。本综述探讨了脂蛋白(a) [Lp(a)]与PAD相关的证据，这是及时的，因为降低Lp(a)的新疗法目前正在一些临床试验中进行测试。近期发现：人体观察性研究表明，Lp(a)水平升高与PAD发病率增加、慢性肢体威胁缺血严重程度和主要肢体不良事件之间存在密切关联。新兴疗法包括小干扰RNA、反义寡核苷酸、蛋白转化酶枯草素-酮蛋白9型抑制剂和脂蛋白分离，均显示出显著的Lp(a)降低效果。然而，这些治疗是否有益于PAD患者目前尚不清楚。总结：Lp(a)可能参与PAD的发病机制。降低Lp(a)的治疗可显著减少pad相关事件并改善预后。未来的研究需要在PAD患者中测试降低Lp(a)的治疗方法，探索Lp(a)的相关性在不同性别和种族中的差异，并了解Lp(a)可能导致肢体缺血的机制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current opinion in lipidology 医学-内分泌学与代谢

CiteScore

6.70

自引率

4.50%

发文量

审稿时长

6-12 weeks

期刊介绍： With its easy-to-digest reviews on important advances in world literature, Current Opinion in Lipidology offers expert evaluation on a wide range of topics from six key disciplines including nutrition and metabolism, genetics and molecular biology, and hyperlipidaemia and cardiovascular disease. Published bimonthly, each issue covers in detail the most pertinent advances in these fields from the previous year. This is supplemented by a section of Bimonthly Updates, which deliver an insight into new developments at the cutting edge of the disciplines covered in the journal.