Nasoufidou Athina, Glava Agni, Mavridou Maria, Stachteas Panagiotis, Karagiannidis Efstratios, Patoulias Dimitrios, Kassimis George, Fragakis Nikolaos, Kavga Maria
Second Cardiology Department, Medical School, Hippokration General Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
4th Department of Pediatrics, Papageorgiou General Hospital, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Ring Road, Municipality of Pavlou Mela, Area N. Evkarpia, 56429 Thessaloniki, Greece.
J Clin Med. 2025 Aug 26;14(17):6018. doi: 10.3390/jcm14176018.
Lipoprotein(a) [Lp(a)] has emerged as a significant independent risk factor for atherosclerotic cardiovascular disease (ASCVD). While plasma Lp(a) levels remain relatively stable throughout life, their clinical impact varies depending on age and concentration. This comprehensive review examines the age-dependent clinical relevance of Lp(a), from childhood through adulthood. In pediatric populations, elevated Lp(a) levels are associated with early indicators of vascular dysfunction and with conditions like familial hypercholesterolemia (FH). In adults, elevated Lp(a) is consistently linked to an increased risk of myocardial infarction (MI), stroke, and calcific aortic valve disease, particularly in those with additional cardiovascular risk factors. We also discuss emerging therapies targeting Lp(a) that may significantly alter long-term cardiovascular risk if implemented early. Understanding the lifelong implications of elevated Lp(a) highlights the need for age-specific strategies for screening, monitoring, and intervention. Future research should prioritize identifying high-risk pediatric populations, refining risk thresholds, and determining optimal timing for therapeutic initiation to improve long-term cardiovascular outcomes.
脂蛋白(a)[Lp(a)]已成为动脉粥样硬化性心血管疾病(ASCVD)的一个重要独立危险因素。虽然血浆Lp(a)水平在一生中相对稳定，但其临床影响因年龄和浓度而异。这篇综述探讨了从儿童期到成年期Lp(a)与年龄相关的临床相关性。在儿科人群中，Lp(a)水平升高与血管功能障碍的早期指标以及家族性高胆固醇血症(FH)等疾病有关。在成年人中，Lp(a)升高一直与心肌梗死(MI)、中风和钙化性主动脉瓣疾病的风险增加有关，特别是在那些有其他心血管危险因素的人群中。我们还讨论了针对Lp(a)的新兴疗法，如果早期实施，可能会显著改变长期心血管风险。了解Lp(a)升高对一生的影响突出了针对不同年龄的筛查、监测和干预策略的必要性。未来的研究应优先确定高危儿科人群，完善风险阈值，并确定治疗开始的最佳时机，以改善长期心血管结局。
