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脂蛋白(a)作为有争议的临床情况下的心血管风险因素:一个叙述性综述。

Lipoprotein (a) as a Cardiovascular Risk Factor in Controversial Clinical Scenarios: A Narrative Review.

机构信息

Department of Internal Medicine, Mayo Clinic, Phoenix, AZ 85054, USA.

Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USA.

出版信息

Int J Mol Sci. 2024 Oct 14;25(20):11029. doi: 10.3390/ijms252011029.


DOI:10.3390/ijms252011029
PMID:39456811
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11507037/
Abstract

Lipoprotein (a) is a complex lipid molecule that has sparked immense interest in recent years, after studies demonstrated its significant association with several cardiovascular conditions. Lp(a) promotes cardiovascular disease through its combined proatherogenic, pro-inflammatory, and prothrombotic effects. While the measurement of Lp(a) has become widely available, effective methods to reduce its concentration are currently limited. However, emerging data from ongoing clinical trials involving antisense oligonucleotides have indicated promising outcomes in effectively reducing Lp(a) concentrations. This may serve as a potential therapeutic target in the management and prevention of myocardial infarction, calcific aortic stenosis, and cerebrovascular accidents. In contrast, the role of Lp(a) in atrial fibrillation, in-stent restenosis, cardiac allograft vasculopathy, and bioprosthetic aortic valve degeneration remains unclear. This review article aims to thoroughly review the existing literature and provide an updated overview of the evidence surrounding the association of Lp(a) and these cardiovascular diseases. We seek to highlight controversies in the existing literature and offer directions for future investigations to better understand Lp(a)'s precise role in these conditions, while providing a summary of its unique molecular characteristics.

摘要

脂蛋白(a)是一种复杂的脂质分子,近年来研究表明其与多种心血管疾病密切相关,引起了广泛关注。脂蛋白(a) 通过其促动脉粥样硬化、促炎和促血栓形成的综合作用促进心血管疾病的发生。虽然脂蛋白(a)的测量已经广泛应用,但目前降低其浓度的有效方法有限。然而,正在进行的涉及反义寡核苷酸的临床试验的最新数据表明,有效降低脂蛋白(a)浓度具有很大的前景。这可能成为管理和预防心肌梗死、钙化性主动脉瓣狭窄和脑血管意外的潜在治疗靶点。相比之下,脂蛋白(a)在心房颤动、支架内再狭窄、心脏移植血管病和生物瓣主动脉瓣退行性变中的作用尚不清楚。这篇综述文章旨在全面回顾现有文献,提供有关脂蛋白(a)与这些心血管疾病关联的最新证据概述。我们旨在强调现有文献中的争议,并为未来的研究提供方向,以更好地了解脂蛋白(a)在这些疾病中的确切作用,并总结其独特的分子特征。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee76/11507037/e2eca2782ba0/ijms-25-11029-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee76/11507037/eb908fdf18d9/ijms-25-11029-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee76/11507037/e2eca2782ba0/ijms-25-11029-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee76/11507037/eb908fdf18d9/ijms-25-11029-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee76/11507037/e2eca2782ba0/ijms-25-11029-g002.jpg

相似文献

[1]
Lipoprotein (a) as a Cardiovascular Risk Factor in Controversial Clinical Scenarios: A Narrative Review.

Int J Mol Sci. 2024-10-14

[2]
Experimental Animal Models Evaluating the Causal Role of Lipoprotein(a) in Atherosclerosis and Aortic Stenosis.

Cardiovasc Drugs Ther. 2016-2

[3]
What is the ultimate test that lowering lipoprotein(a) is beneficial for cardiovascular disease and aortic stenosis?

Curr Opin Lipidol. 2014-12

[4]
Lipoprotein(a) and calcific aortic valve stenosis: A systematic review.

Prog Cardiovasc Dis. 2020-6-8

[5]
The journey towards understanding lipoprotein(a) and cardiovascular disease risk: are we there yet?

Curr Opin Lipidol. 2018-6

[6]
Emerging Therapeutic Options for Lowering of Lipoprotein(a): Implications for Prevention of Cardiovascular Disease.

Curr Atheroscler Rep. 2016-12

[7]
Daring to dream: Targeting lipoprotein(a) as a causal and risk-enhancing factor.

Pharmacol Res. 2023-8

[8]
Lipoprotein(a): Expanding our knowledge of aortic valve narrowing.

Trends Cardiovasc Med. 2021-7

[9]
Lipoprotein(a): a genetic marker for cardiovascular disease and target for emerging therapies.

J Cardiovasc Med (Hagerstown). 2021-3-1

[10]
The re-emergence of lipoprotein(a) in a broader clinical arena.

Prog Cardiovasc Dis. 2016-8-3

引用本文的文献

[1]
Impact of Elevated Lipoprotein A on Major Adverse Cardiovascular Events and the Role of Traditional Risk Factors in Patients Undergoing Percutaneous Coronary Intervention.

Cureus. 2025-1-18

[2]
Special Issue: "New Trends in Diabetes, Hypertension, and Cardiovascular Diseases-2nd Edition".

Int J Mol Sci. 2025-1-7

本文引用的文献

[1]
Relationship between carotid atherosclerosis and lipoprotein (a) in patients with acute ischemic stroke.

Front Neurol. 2024-6-26

[2]
Lipoprotein(a) and long-term in-stent restenosis after percutaneous coronary intervention.

Eur J Prev Cardiol. 2024-11-11

[3]
A focused update to the 2019 NLA scientific statement on use of lipoprotein(a) in clinical practice.

J Clin Lipidol. 2024

[4]
Aspirin and Cardiovascular Risk in Individuals With Elevated Lipoprotein(a): The Multi-Ethnic Study of Atherosclerosis.

J Am Heart Assoc. 2024-2-6

[5]
Lipoprotein(a) Is Markedly More Atherogenic Than LDL: An Apolipoprotein B-Based Genetic Analysis.

J Am Coll Cardiol. 2024-1-23

[6]
Elevated Lipoprotein A Levels and Development of Moderate or Severe Cardiac Allograft Vasculopathy in Patients with Heart Transplants.

Transplant Proc. 2023-12

[7]
Role of lipoprotein(a) concentrations in bioprosthetic aortic valve degeneration.

Heart. 2024-1-29

[8]
Association Between Lipoprotein (a) and Risk of Atrial Fibrillation: A Systematic Review and Meta-analysis of Mendelian Randomization Studies.

Curr Probl Cardiol. 2024-1

[9]
Clinical Trial Design for Lipoprotein(a)-Lowering Therapies: JACC Focus Seminar 2/3.

J Am Coll Cardiol. 2023-4-25

[10]
Lipoprotein(a): cardiovascular risk and emerging therapies.

Expert Rev Cardiovasc Ther. 2023-4

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