脂蛋白(a)：现代基因组学的新见解
Lipoprotein(a): new insights from modern genomics.
作者信息
Afshar Mehdi, Thanassoulis George
机构信息
aDepartment of Medicine, McGill University bPreventive and Genomic Cardiology, McGill University Health Center and Research Institute cDepartment of Clinical Epidemiology, McGill University Health Center, Montreal, Quebec, Canada.
出版信息
Curr Opin Lipidol. 2017 Apr;28(2):170-176. doi: 10.1097/MOL.0000000000000392.
PURPOSE OF REVIEW
Lipoprotein(a) [Lp(a)] is the strongest independent genetic risk factor for both myocardial infarction and aortic stenosis. It has also been associated with other forms of atherosclerotic cardiovascular disease (CVD) including ischemic stroke. Its levels are genetically determined and remain fairly stable throughout life. Elevated Lp(a), above 50 mg/dl, affects one in five individuals worldwide.
RECENT FINDINGS
Herein, we review the recent epidemiologic and genetic evidence supporting the causal role of Lp(a) in CVD, highlight recommendations made by European and Canadian guidelines regarding Lp(a) and summarize the rapidly evolving field of Lp(a)-lowering therapies including antisense therapies and Proprotein Convertase Subtilisin/Kexin Type 9 inhibitors.
SUMMARY
With novel therapies on the horizon, Lp(a) is poised to gain significant clinical relevance and its lowering could have a significant impact on the burden of CVD. VIDEO ABSTRACT.
综述目的
脂蛋白(a)[Lp(a)]是心肌梗死和主动脉瓣狭窄最强的独立遗传风险因素。它还与包括缺血性中风在内的其他形式的动脉粥样硬化性心血管疾病（CVD）有关。其水平由基因决定，且在一生中保持相当稳定。Lp(a)水平高于50mg/dl在全球五分之一的个体中存在。
最新发现
在此，我们回顾支持Lp(a)在CVD中因果作用的最新流行病学和遗传学证据，强调欧洲和加拿大指南关于Lp(a)的建议，并总结Lp(a)降低疗法快速发展的领域，包括反义疗法和前蛋白转化酶枯草杆菌蛋白酶/kexin 9型抑制剂。
总结
随着新疗法即将出现，Lp(a)有望具有重要的临床意义，降低Lp(a)可能对CVD负担产生重大影响。视频摘要。
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