RNA therapeutics
Emerging apo(a)-targeted therapies could transform Lp(a) management, a review of Lp(a)'s role in preventive cardiology (Curr Opin Cardiol 2019)
Original title: Current and future role of lipoprotein(a) in preventive cardiology
This review by Berman and Blankstein surveys the emerging understanding of Lp(a) role in atherosclerotic cardiovascular disease (ASCVD), its structure-function relationship, and developments in the Lp(a)-lowering therapeutic pipeline. Elevated Lp(a) is strongly associated with coronary heart disease, calcific aortic valve stenosis and ischaemic stroke, and because circulating levels are almost exclusively genetically determined, elevated Lp(a) contributes significantly to residual cardiovascular risk even when other risk factors are well controlled. Lp(a) unique structure, a genetically heterogeneous apolipoprotein(a) molecule bound to an LDL-like moiety, both explains its pathogenic role and complicates accurate measurement. The authors highlight emerging therapies targeting the apolipoprotein(a) component as having the potential to transform management of elevated Lp(a) and add a new option for cardiovascular disease prevention.
Original abstract
Purpose Of Review: The purpose of this review is to highlight our emerging understanding of lipoprotein(a) [Lp(a)]'s role in atherosclerotic cardiovascular disease (ASCVD), its structure-function relationship, and promising developments within the therapeutic pipeline.
Recent Findings: Elevated levels of Lp(a) are strongly associated with an increased risk of coronary heart disease, calcific aortic valve stenosis, and ischemic stroke. With circulating levels almost exclusively genetically mediated, increased levels of Lp(a) contribute significantly to the residual cardiovascular disease risk in individuals with otherwise well controlled risk factors. The unique structure of Lp(a) - comprised of a genetically heterogeneous apolipoprotein(a) molecule bound to an LDL-like moiety - provides insight into its pathogenic role in cardiovascular disease and also complicates its accurate measurement. Emerging therapies targeting the apolipoprotein(a) component of Lp(a) have the potential to revolutionize the management of individuals with elevated Lp(a).
Summary: With promising therapies on the horizon, there has been a renewed focus on the role of Lp(a) in ASCVD. Given Lp(a)'s strong and independent association with key cardiovascular outcomes, it is hopeful that these promising targeted therapies will add another therapeutic option for the prevention of cardiovascular disease.
aortic stenosismechanismsRNA therapeuticsstroke
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.