Lp(a): Global Public Health Concern: Emerging Knowledge and Therapeutic Approaches.

IF 3.1 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Cardiology Reports Pub Date : 2025-06-25 DOI:10.1007/s11886-025-02255-2

Alexander C Razavi, Jessica Hong, Harpreet S Bhatia

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引用次数: 0

Abstract

Purpose of review: Lipoprotein(a) [Lp(a)] is an apolipoprotein B-containing lipoprotein that is a genetic causal risk factor for atherosclerotic cardiovascular disease (ASCVD) and calcific aortic valve disease. This review focuses on new findings and treatment approaches for individuals with elevated Lp(a) across the spectrum of ASCVD.

Recent findings: One in five individuals globally have elevated Lp(a) (> 125 nmol/L or > 50 mg/dL). Emerging knowledge related to Lp(a) includes demonstration of poor rates of Lp(a) testing, comparison of methods for Lp(a) measurement, natural variability in Lp(a) levels, the continuous association between Lp(a) and ASCVD risk, atherogenicity in comparison with LDL, risk in context of other risk factors, coronary plaque characteristics, and the association of Lp(a) with a broader range of outcomes. Optimal risk factor control, including LDL-cholesterol lowering, is a cornerstone of management. When indicated, shared decision-making to discuss antiplatelet therapy for individuals with very-high Lp(a) may also be helpful. Several Lp(a)-lowering therapies are under investigation in ASCVD outcome trials. While Lp(a) is a well-established risk factor for ASCVD, there are several areas of growing knowledge related to Lp(a), and management strategies of individuals with elevated Lp(a) continue to evolve with targeted therapies currently in late-stage clinical trials.

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Lp(a)：全球公共卫生关注：新兴知识和治疗方法。

综述目的：脂蛋白(a) [Lp(a)]是一种含载脂蛋白b的脂蛋白，是动脉粥样硬化性心血管疾病（ASCVD）和钙化性主动脉瓣疾病的遗传因果危险因素。本文综述了ASCVD患者Lp(a)升高的新发现和治疗方法。最近的发现：全球五分之一的人Lp(a)升高（> 125 nmol/L或> 50 mg/dL）。与Lp(a)相关的新兴知识包括Lp(a)检测的不良率证明、Lp(a)测量方法的比较、Lp(a)水平的自然变异性、Lp(a)与ASCVD风险之间的持续关联、与LDL相比的动脉粥样硬化性、其他危险因素背景下的风险、冠状动脉斑块特征以及Lp(a)与更广泛结果的关联。最佳的风险因素控制，包括降低低密度脂蛋白胆固醇，是管理的基石。当有指示时，共同决策讨论抗血小板治疗的个人非常高的Lp(a)也可能是有帮助的。ASCVD结局试验正在研究几种降低Lp(a)的疗法。虽然Lp(a)是ASCVD的一个公认的危险因素，但与Lp(a)相关的几个领域的知识不断增长，并且Lp(a)升高个体的管理策略继续发展，目前处于后期临床试验的靶向治疗。

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 Cardiology Reports CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

6.20

自引率

2.70%

发文量

209

期刊介绍： The aim of this journal is to provide timely perspectives from experts on current advances in cardiovascular medicine. We also seek to provide reviews that highlight the most important recently published papers selected from the wealth of available cardiovascular literature. We accomplish this aim by appointing key authorities in major subject areas across the discipline. Section editors select topics to be reviewed by leading experts who emphasize recent developments and highlight important papers published over the past year. An Editorial Board of internationally diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research. We also provide commentaries from well-known figures in the field.