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Deprecated: Implicit conversion from float 247.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Curr+Opin+Endocrinol+Diabetes+Obes 2016 ; 23 (2): 157-64 Nephropedia Template TP
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Lp(a) as a new target for reduction of risk of cardiovascular disease and emergence of novel therapies to lower Lp(a) #MMPMID26825471
Purpose of review: The purpose of this review is to summarize recent observations on the role of lipoprotein(a) [Lp(a)] as a risk factor mediating cardiovascular disease. Recent findings: Lp(a) is a highly prevalent cardiovascular risk factor, with levels >30 mg/dL affecting 20?30% of the global population. Up until now, no specific therapies have been developed to lower Lp(a) levels. Three major levels of evidence support the notion that elevated Lp(a) levels are a causal, independent, genetic risk factor for cardiovascular disease; epidemiologic studies and meta-analyses, genome wide association studies and mendelian randomization studies. Recent studies also have noted that individuals with low levels of Lp(a) are associated with a higher risk of incident type 2 diabetes mellitus, and conversely individuals with high levels have a lower risk, but this association does not appear to be causal. Novel therapies to lower Lp(a) include PCSK9 inhibitors and antisense oligonucleotides directly preventing translation of apolipoprotein(a) mRNA. Summary: With this robust and expanding clinical database, a re-awakening of interest in Lp(a) as clinical risk factor is taking place. Trials are underway with novel drugs that substantially lower Lp(a) and may reduce its contribution to cardiovascular disease.