Genetics
Lp(a) is a proven causal cardiovascular risk factor but still lacks a specific therapy or standardised test, a review (J Clin Med 2019)
Original title: Molecular, Population, and Clinical Aspects of Lipoprotein(a): A Bridge Too Far?
This review by Ward, Kostner, Sullivan, Nestel and Watts surveys the molecular, population and clinical aspects of lipoprotein(a) [Lp(a)]. Significant evidence supports Lp(a) as an independent causal risk factor for atherosclerotic cardiovascular disease, with plasma concentrations predominantly genetically determined, though research remains hampered by incomplete understanding of Lp(a) metabolism and proatherogenic properties and a lack of suitable animal models. No standardised assay or universal consensus on optimal Lp(a) levels yet exists, and no approved therapy specifically targets and lowers Lp(a), despite limited clinical outcome data suggesting benefit from Lp(a) reduction. Despite these gaps, international guidelines now recognise elevated Lp(a) as a risk-enhancing factor for cardiovascular risk reclassification. The review covers Lp(a) discovery, standardisation efforts, interpopulation studies, and emerging Lp(a)-lowering therapies.
Original abstract
There is now significant evidence to support an independent causal role for lipoprotein(a) (Lp(a)) as a risk factor for atherosclerotic cardiovascular disease. Plasma Lp(a) concentrations are predominantly determined by genetic factors. However, research into Lp(a) has been hampered by incomplete understanding of its metabolism and proatherogeneic properties and by a lack of suitable animal models. Furthermore, a lack of standardized assays to measure Lp(a) and no universal consensus on optimal plasma levels remain significant obstacles. In addition, there are currently no approved specific therapies that target and lower elevated plasma Lp(a), although there are recent but limited clinical outcome data suggesting benefits of such reduction. Despite this, international guidelines now recognize elevated Lp(a) as a risk enhancing factor for risk reclassification. This review summarises the current literature on Lp(a), including its discovery and recognition as an atherosclerotic cardiovascular disease risk factor, attempts to standardise analytical measurement, interpopulation studies, and emerging therapies for lowering elevated Lp(a) levels.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.