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Volume 9
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10.3390/biomedicines9070838
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Review

Lipoprotein(a) Where Do We Stand? From the Physiopathology to Innovative Terapy

by
Gabriella Iannuzzo
1,*,
Maria Tripaldella
1,
Vania Mallardo
1,
Mena Morgillo
1,
Nicoletta Vitelli
1,
Arcangelo Iannuzzi
2,
Emilio Aliberti
3,
Francesco Giallauria
4,
Anna Tramontano
4,
Raffaele Carluccio
4,
Ilenia Calcaterra
1,
Matteo Nicola Dario Di Minno
1 and
Marco Gentile
1
1
Department of Clinical Medicine and Surgery, “Federico II” University, 80131 Naples, Italy
2
Department of Medicine and Medical Specialties, A. Cardarelli Hospital, 80131 Naples, Italy
3
North Tees University Hospital Stockton-on-Tees, Stockton TS19 8PE, UK
4
Department of Translational Medical Sciences, “Federico II” University of Naples, Via S. Pansini 5, 80131 Naples, Italy
*
Author to whom correspondence should be addressed.
Biomedicines 2021, 9(7), 838; https://doi.org/10.3390/biomedicines9070838
Submission received: 9 June 2021 / Revised: 2 July 2021 / Accepted: 9 July 2021 / Published: 19 July 2021
(This article belongs to the Special Issue Lipoproteins and Cardiovascular Diseases)
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Abstract

A number of epidemiologic studies have demonstrated a strong association between increasing lipoprotein a [Lp(a)] and cardiovascular disease. This correlation was demonstrated independent of other known cardiovascular (CV) risk factors. Screening for Lp(a) in the general population is not recommended, although Lp(a) levels are predominantly genetically determined so a single assessment is needed to identify patients at risk. In 2019 ESC/EAS guidelines recommend Lp(a) measurement at least once a lifetime, fo subjects at very high and high CV risk and those with a family history of premature cardiovascular disease, to reclassify patients with borderline risk. As concerning medications, statins play a key role in lipid lowering therapy, but present poor efficacy on Lp(a) levels. Actually, treatment options for elevated serum levels of Lp(a) are very limited. Apheresis is the most effective and well tolerated treatment in patients with high levels of Lp(a). However, promising new therapies, in particular antisense oligonucleotides have showed to be able to significantly reduce Lp(a) in phase II RCT. This review provides an overview of the biology and epidemiology of Lp(a), with a view to future therapies.
Keywords: lipoprotein(a); cardiovascular risk; lipoprotein apheresis; antisense oligonucleotide APO(a)Lrx lipoprotein(a); cardiovascular risk; lipoprotein apheresis; antisense oligonucleotide APO(a)Lrx

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MDPI and ACS Style

Iannuzzo, G.; Tripaldella, M.; Mallardo, V.; Morgillo, M.; Vitelli, N.; Iannuzzi, A.; Aliberti, E.; Giallauria, F.; Tramontano, A.; Carluccio, R.; et al. Lipoprotein(a) Where Do We Stand? From the Physiopathology to Innovative Terapy. Biomedicines 2021, 9, 838. https://doi.org/10.3390/biomedicines9070838

AMA Style

Iannuzzo G, Tripaldella M, Mallardo V, Morgillo M, Vitelli N, Iannuzzi A, Aliberti E, Giallauria F, Tramontano A, Carluccio R, et al. Lipoprotein(a) Where Do We Stand? From the Physiopathology to Innovative Terapy. Biomedicines. 2021; 9(7):838. https://doi.org/10.3390/biomedicines9070838

Chicago/Turabian Style

Iannuzzo, Gabriella, Maria Tripaldella, Vania Mallardo, Mena Morgillo, Nicoletta Vitelli, Arcangelo Iannuzzi, Emilio Aliberti, Francesco Giallauria, Anna Tramontano, Raffaele Carluccio, and et al. 2021. "Lipoprotein(a) Where Do We Stand? From the Physiopathology to Innovative Terapy" Biomedicines 9, no. 7: 838. https://doi.org/10.3390/biomedicines9070838

APA Style

Iannuzzo, G., Tripaldella, M., Mallardo, V., Morgillo, M., Vitelli, N., Iannuzzi, A., Aliberti, E., Giallauria, F., Tramontano, A., Carluccio, R., Calcaterra, I., Di Minno, M. N. D., & Gentile, M. (2021). Lipoprotein(a) Where Do We Stand? From the Physiopathology to Innovative Terapy. Biomedicines, 9(7), 838. https://doi.org/10.3390/biomedicines9070838

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