Lipoprotein (a): diagnosis, pathogenetic and clinical significance

Abstract

Despite the active treatment of statins in patients with cardiovascular diseases and the achievement of target values of lipoproteins, the number of repeated myocardial infarctions, restenosis inside the stent, progression of coronary heart disease (CHD) does not decrease. This review of foreign and domestic literature presents modern views on the role of lipoprotein(a) in the development of coronary heart disease, aortic stenosis, the development of cardiovascular events. Elevated Lp(a) levels are considered a genetically determined risk factor for cardiovascular diseases. Lp(а) consists of an apolipoprotein B-containing low-density lipoprotein (LDL)-like particle, covalently linked to the plasminogen-like glycoprotein apo(a). The level of Lp(a) is genetically controlled by LPA gene. To date, several types of interventions have been developed for reducing Lp(a) levels. Three of them are successful: therapy with proprotein convertase subtilisin kexin type 9 inhibitors - (PCSK9), lipid apheresis, antisense therapy.