Universität zu Köln

Gouni-Berthold, Ioanna and Berthold, Heiner K. (2011). Lipoprotein(a): Current Perspectives. Current Vascular Pharmacology, 9 (6). S. 682 - 693. SHARJAH: BENTHAM SCIENCE PUBL LTD. ISSN 1875-6212

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Abstract

Recent data from genetic and epidemiological studies strongly support a causal relationship between elevated lipoprotein(a) [Lp(a)] concentrations and the development of atherosclerosis and cardiovascular disease. This relationship is continuous, without an Lp(a) threshold, and it is independent of low density lipoprotein and high density lipoprotein cholesterol (LDL-C and HDL-C, respectively) levels. Although the mechanism(s) through which Lp(a) promotes atherosclerosis are not clearly understood, proposed mechanisms include an increased Lp(a)-associated cholesterol entrapment in the arterial intima, inflammatory cell recruitment, carrying of proinflammatory oxidized phospholipids, impairing fibrinolysis by inhibition of plasminogen activation and enhancing coagulation by inhibition of the tissue factor pathway inhibitor. Phenotypically there are two forms, isolated hyperlipoproteinemia(a) in the presence of normal LDL-C, and combined elevations of Lp(a) and LDL-C. There are no drugs or other therapeutic options available that selectively decrease Lp(a). Those that can lower Lp(a) levels only have a moderate effect and their actions include decreasing LDL-C levels. The strongest effects are seen with niacin at high doses. Nevertheless, there is no convincing evidence that decreasing isolated elevations of Lp(a) offers cardiovascular benefit. This review considers the evidence supporting the association between Lp(a) and atherosclerotic disease, discusses the potential mechanisms involved in the pro-atherosclerotic potential of Lp(a), and evaluates the therapeutic options that decrease elevated Lp(a) levels.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Gouni-Berthold, Ioanna UNSPECIFIED UNSPECIFIED UNSPECIFIED Berthold, Heiner K. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-485648
DOI:	10.2174/157016111797484071
Journal or Publication Title:	Current Vascular Pharmacology
Volume:	9
Number:	6
Page Range:	S. 682 - 693
Date:	2011
Publisher:	BENTHAM SCIENCE PUBL LTD
Place of Publication:	SHARJAH
ISSN:	1875-6212
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language HORMONE REPLACEMENT THERAPY; LOW-DENSITY-LIPOPROTEIN; EXTENDED-RELEASE NIACIN; CORONARY-HEART-DISEASE; LOWERS SERUM LIPOPROTEIN(A); CARDIOVASCULAR RISK-FACTORS; C-REACTIVE PROTEIN; PLASMA LIPOPROTEIN(A); L-CARNITINE; APOLIPOPROTEIN-B Multiple languages Pharmacology & Pharmacy; Peripheral Vascular Disease Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/48564