Department of Internal Medicine, Mayo Clinic, Phoenix, AZ 85054, USA.
Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USA.
Int J Mol Sci. 2024 Oct 14;25(20):11029. doi: 10.3390/ijms252011029.
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.
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。
