Skip to main content
SpringerLink
Log in

The Role of Lp(a) in Atherosclerosis: An Overview

  • Chapter
  • First Online:
Lipoprotein(a)

Part of the book series: Contemporary Cardiology ((CONCARD))

  • 524 Accesses

Abstract

Epidemiological, Mendelian randomization, and genome-wide association studies (GWAS) have established that high levels of Lipoprotein(a) [Lp(a)] are causal for atherosclerotic cardiovascular disease (ASCVD). Lp(a) is an apolipoprotein B100 (apoB100)-containing particle that circulates in human plasma, distinguished by its lipid composition and presence of apolipoprotein(a) [apo(a)]. Plasma levels of Lp(a) are primarily genetically determined and vary significantly among different ethnicities. The role of Lp(a) as a contributor to atherogenic processes has been studied by various authors, but its exact pathophysiology, independent of conventional apoB injury, has not been completely described. Advancements in mass spectrometry have enhanced the ability to study Lp(a) composition further. These new tools have led to identification of novel pathways unique to Lp(a), which may explain its pathogenic nature and links to ASCVD, mainly, via the oxidized phospholipid pathway and propagation of the inflammatory cascade. In this overview, we provide brief updates on the role of Lp(a) in myocardial infarction, aortic stenosis, stroke, and peripheral artery disease, highlighting its relevance to disease outcomes, genetics, and role of potential treatments.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 189.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Afanasieva OI, Ezhov MV, Tmoyan NA, Razova OA, Afanasieva MI, Matchin YG, Pokrovsky SN. Low molecular weight apolipoprotein(a) phenotype rather than lipoprotein(a) is associated with coronary atherosclerosis and myocardial infarction. Front Cardiovasc Med. 2022;9:843602.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Arora P, Kalra R, Callas PW, Alexander KS, Zakai NA, Wadley V, Arora G, Kissela BM, Judd SE, Cushman M. Lipoprotein(a) and risk of ischemic stroke in the REGARDS study. Arterioscler Thromb Vasc Biol. 2019;39:810–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Arsenault BJ, Kamstrup PR. Lipoprotein(a) and cardiovascular and valvular diseases: a genetic epidemiological perspective. Atherosclerosis. 2022;349:7–16.

    CAS  PubMed  Google Scholar 

  • Arsenault BJ, Pelletier W, Kaiser Y, Perrot N, Couture C, Khaw KT, Wareham NJ, Bosse Y, Pibarot P, Stroes ESG, Mathieu P, Theriault S, Boekholdt SM. Association of long-term exposure to elevated lipoprotein(a) levels with parental life span, chronic disease-free survival, and mortality risk: a mendelian randomization analysis. JAMA Netw Open. 2020;3:e200129.

    PubMed  PubMed Central  Google Scholar 

  • Bennet A, Di Angelantonio E, Erqou S, Eiriksdottir G, Sigurdsson G, Woodward M, Rumley A, Lowe GD, Danesh J, Gudnason V. Lipoprotein(a) levels and risk of future coronary heart disease: large-scale prospective data. Arch Intern Med. 2008;168:598–608.

    CAS  PubMed  Google Scholar 

  • Berg K. A new serum type system in man-the LP system. Acta Pathol Microbiol Scand. 1963;59:369–82.

    CAS  PubMed  Google Scholar 

  • Berliner JA, Watson AD. A role for oxidized phospholipids in atherosclerosis. N Engl J Med. 2005;353:9–11.

    CAS  PubMed  Google Scholar 

  • Boffa MB. Beyond fibrinolysis: the confounding role of Lp(a) in thrombosis. Atherosclerosis. 2022;349:72–81. https://pubmed.ncbi.nlm.nih.gov/35606079/.

    CAS  PubMed  Google Scholar 

  • Bourgeois R, Bourgault J, Despres AA, Perrot N, Guertin J, Girard A, Mitchell PL, Gotti C, Bourassa S, Scipione CA, Gaudreault N, Boffa MB, Koschinsky ML, Pibarot P, Droit A, Theriault S, Mathieu P, Bosse Y, Arsenault BJ. Lipoprotein proteomics and aortic valve transcriptomics identify biological pathways linking lipoprotein(a) levels to aortic stenosis. Metabolites. 2021;11:459.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Burgess S, Ference BA, Staley JR, Freitag DF, Mason AM, Nielsen SF, Willeit P, Young R, Surendran P, Karthikeyan S, Bolton TR, Peters JE, Kamstrup PR, Tybjaerg-Hansen A, Benn M, Langsted A, Schnohr P, Vedel-Krogh S, Kobylecki CJ, Ford I, Packard C, Trompet S, Jukema JW, Sattar N, Di Angelantonio E, Saleheen D, Howson JMM, Nordestgaard BG, Butterworth AS, Danesh J, European Prospective Investigation Into C and Nutrition-Cardiovascular Disease C. Association of LPA variants with risk of coronary disease and the implications for lipoprotein(a)-lowering therapies: a mendelian randomization analysis. JAMA Cardiol. 2018;3:619–27.

    PubMed  PubMed Central  Google Scholar 

  • Chemello K, Chan DC, Lambert G, Watts GF. Recent advances in demystifying the metabolism of lipoprotein(a). Atherosclerosis. 2022;349:82–91.

    CAS  PubMed  Google Scholar 

  • Clarke R, Peden JF, Hopewell JC, Kyriakou T, Goel A, Heath SC, Parish S, Barlera S, Franzosi MG, Rust S, Bennett D, Silveira A, Malarstig A, Green FR, Lathrop M, Gigante B, Leander K, de Faire U, Seedorf U, Hamsten A, Collins R, Watkins H, Farrall M. Genetic variants associated with Lp(a) lipoprotein level and coronary disease. N Engl J Med. 2009;361:2518–28.

    CAS  PubMed  Google Scholar 

  • Coassin S, Kronenberg F. Lipoprotein(a) beyond the kringle IV repeat polymorphism: the complexity of genetic variation in the LPA gene. Atherosclerosis. 2022;349:17–35.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Colantonio LD, Bittner V, Safford MM, Marcovina S, Brown TM, Jackson EA, Li M, Lopez JAG, Monda KL, Plante TB, Kent ST, Muntner P, Rosenson RS. Lipoprotein(a) and the risk for coronary heart disease and ischemic stroke events among black and white adults with cardiovascular disease. J Am Heart Assoc. 2022;11:e025397.

    PubMed  PubMed Central  Google Scholar 

  • Emerging Risk Factors Collaboration, Erqou S, Kaptoge S, Perry PL, Di Angelantonio E, Thompson A, White IR, Marcovina SM, Collins R, Thompson SG, Danesh J. Lipoprotein(a) concentration and the risk of coronary heart disease, stroke, and nonvascular mortality. JAMA. 2009;302:412–23.

    Google Scholar 

  • Enkhmaa BAE, Berglund L. Lipoprotein(a): impact by ethnicity and environmental and medical conditions. J Lipid Res. 2016;57:1111–25.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Erqou S, Kaptoge S, Perry PL, Emerging Risk Factors Collaboration. Lipoprotein(a) concentration and the risk of coronary heart disease, stroke, and nonvascular mortality. JAMA. 2009;302:412–23.

    CAS  PubMed  Google Scholar 

  • Forbang NI, Criqui MH, Allison MA, Ix JH, Steffen BT, Cushman M, Tsai MY. Sex and ethnic differences in the associations between lipoprotein(a) and peripheral arterial disease in the Multi-Ethnic Study of Atherosclerosis. J Vasc Surg. 2016;63:453–8.

    PubMed  Google Scholar 

  • Heigl F, Hettich R, Lotz N, Reeg H, Pflederer T, Osterkorn D, Osterkorn K, Klingel R. Efficacy, safety, and tolerability of long-term lipoprotein apheresis in patients with LDL- or Lp(a) hyperlipoproteinemia: Findings gathered from more than 36,000 treatments at one center in Germany. Atheroscler Suppl. 2015;18:154–62.

    PubMed  Google Scholar 

  • Jawi MM, Frohlich J, Chan SY. Lipoprotein(a) the insurgent: a new insight into the structure, function, metabolism, pathogenicity, and medications affecting lipoprotein(a) molecule. J Lipids. 2020;2020:3491764.

    PubMed  PubMed Central  Google Scholar 

  • Kaiser Y, Daghem M, Tzolos E, Meah MN, Doris MK, Moss AJ, Kwiecinski J, Kroon J, Nurmohamed NS, van der Harst P, Adamson PD, Williams MC, Dey D, Newby DE, Stroes ESG, Zheng KH, Dweck MR. Association of lipoprotein(a) with atherosclerotic plaque progression. J Am Coll Cardiol. 2022;79:223–33.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Kamstrup PR, Nordestgaard BG. Elevated lipoprotein(a) levels, LPA risk genotypes, and increased risk of heart failure in the general population. JACC Heart Fail. 2016;4:78–87.

    PubMed  Google Scholar 

  • Kamstrup PR, Benn M, Tybjaerg-Hansen A, Nordestgaard BG. Extreme lipoprotein(a) levels and risk of myocardial infarction in the general population: the Copenhagen City Heart Study. Circulation. 2008;117:176–84.

    CAS  PubMed  Google Scholar 

  • Kettunen J, Demirkan A, Wurtz P, Draisma HH, Haller T, Rawal R, Vaarhorst A, Kangas AJ, Lyytikainen LP, Pirinen M, Pool R, Sarin AP, Soininen P, Tukiainen T, Wang Q, Tiainen M, Tynkkynen T, Amin N, Zeller T, Beekman M, Deelen J, van Dijk KW, Esko T, Hottenga JJ, van Leeuwen EM, Lehtimaki T, Mihailov E, Rose RJ, de Craen AJ, Gieger C, Kahonen M, Perola M, Blankenberg S, Savolainen MJ, Verhoeven A, Viikari J, Willemsen G, Boomsma DI, van Duijn CM, Eriksson J, Jula A, Jarvelin MR, Kaprio J, Metspalu A, Raitakari O, Salomaa V, Slagboom PE, Waldenberger M, Ripatti S, Ala-Korpela M. Genome-wide study for circulating metabolites identifies 62 loci and reveals novel systemic effects of LPA. Nat Commun. 2016;7:11122.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Kobiyama K, Ley K. Atherosclerosis. Circ Res. 2018;123:1118–20.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Kosmas CE, Silverio D, Sourlas A, Peralta R, Montan PD, Guzman E, Garcia MJ. Role of lipoprotein(a) in peripheral arterial disease. Ann Transl Med. 2019;7:S242.

    PubMed  PubMed Central  Google Scholar 

  • Kostner KM, Kostner GM. Lipoprotein(a): a historical appraisal. J Lipid Res. 2017;58:1–14.

    CAS  PubMed  Google Scholar 

  • Kraaijenhof JM, Hovingh GK, Stroes ESG, Kroon J. The iterative lipid impact on inflammation in atherosclerosis. Curr Opin Lipidol. 2021;32:286–92.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Kraft HGSC, Menzel HJ, Utermann G. Apolipoprotein(a) alleles determine lipoprotein(a) particle density and concentration in plasma. Atheroscler Thromb. 1992;12:302–6.

    CAS  Google Scholar 

  • Kronenberg F. Lipoprotein(a). Handb Exp Pharmacol. 2022;270:201–32.

    CAS  PubMed  Google Scholar 

  • Kronenberg F, Utermann G. Lipoprotein(a): resurrected by genetics. J Intern Med. 2013;273:6–30.

    CAS  PubMed  Google Scholar 

  • Lackner C, Boerwinkle E, Leffert CC, Rahmig T, Hobbs HH. Molecular basis of apolipoprotein(a) isoform size heterogeneity as revealed by pulsed-field get electrophoresis. J Clin Invest. 1991;87:2077–86.

    Google Scholar 

  • Langsted A, Varbo A, Kamstrup PR, Nordestgaard BG. Elevated lipoprotein(a) does not cause low-grade inflammation despite causal association with aortic valve stenosis and myocardial infarction: a study of 100,578 individuals from the general population. J Clin Endocrinol Metab. 2015;100:2690–9.

    CAS  PubMed  Google Scholar 

  • Langsted A, Kamstrup PR, Nordestgaard BG. High lipoprotein(a) and high risk of mortality. Eur Heart J. 2019;40:2760–70.

    CAS  PubMed  Google Scholar 

  • Libby P. Mechanisms of acute coronary syndromes and their implications for therapy. N Engl J Med. 2013;368:2004–13.

    CAS  PubMed  Google Scholar 

  • Libby P, Buring JE, Badimon L, Hansson GK, Deanfield J, Bittencourt MS, Tokgozoglu L, Lewis EF. Atherosclerosis. Nat Rev Dis Primers. 2019;5:56.

    PubMed  Google Scholar 

  • Loh WJ, Chang X, Aw TC, Phua SK, Low AF, Chan MY, Watts GF, Heng CK. Lipoprotein(a) as predictor of coronary artery disease and myocardial infarction in a multi-ethnic Asian population. Atherosclerosis. 2022;349:160–5.

    CAS  PubMed  Google Scholar 

  • Mach F, Baigent C, Catapano AL, Koskinas KC, Casula M, Badimon L, Chapman MJ, De Backer GG, Delgado V, Ference BA, Graham IM, Halliday A, Landmesser U, Mihaylova B, Pedersen TR, Riccardi G, Richter DJ, Sabatine MS, Taskinen MR, Tokgozoglu L, Wiklund O, Group ESCSD. ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J. 2019;2020(41):111–88.

    Google Scholar 

  • Marchini T, Mitre LS, Wolf D. Inflammatory cell recruitment in cardiovascular disease. Front Cell Dev Biol. 2021;9:635527.

    PubMed  PubMed Central  Google Scholar 

  • Markus MRP, Ittermann T, Schipf S, Bahls M, Nauck M, Volzke H, Santos RD, Peters A, Zeller T, Felix SB, Vasan RS, Thorand B, Steinhagen-Thiessen E, Dorr M. Association of sex-specific differences in lipoprotein(a) concentrations with cardiovascular mortality in individuals with type 2 diabetes mellitus. Cardiovasc Diabetol. 2021;20:168.

    CAS  PubMed  PubMed Central  Google Scholar 

  • McCormick SPA, Schneider WJ. Lipoprotein(a) catabolism: a case of multiple receptors. Pathology. 2018; https://doi.org/10.1016/j.pathol.2018.11.003.

  • Mehta A, Virani SS, Ayers CR, Sun W, Hoogeveen RC, Rohatgi A, Berry JD, Joshi PH, Ballantyne CM, Khera A. Lipoprotein(a) and family history predict cardiovascular disease risk. J Am Coll Cardiol. 2020;76:781–93. PMID: 32792075.

    Google Scholar 

  • Moriarty PM, Gray JV, Gorby LK. Lipoprotein apheresis for lipoprotein(a) and cardiovascular disease. J Clin Lipidol. 2019;13:894–900.

    PubMed  Google Scholar 

  • Nahrendorf M, Pittet MJ, Swirski FK. Monocytes: protagonists of infarct inflammation and repair after myocardial infarction. Circulation. 2010;121:2437–45.

    PubMed  PubMed Central  Google Scholar 

  • Nordestgaard BG, Langsted A. Lipoprotein(a) as a cause of cardiovascular disease: insights from epidemiology, genetics, and biology. J Lipid Res. 2016;57:1953–75.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Nordestgaard BG, Chapman MJ, Ray K, Borén J, Andreotti F, Watts GF, Ginsberg H, Amarenco P, Catapano A, Descamps OS, Fisher E, Kovanen PT, Lesnik P, Masana L, Reiner Z, Taskinen M-R, Tokgözoglu L, Tybjærg-Hansen A, Panel aEASC. Lipoprotein(a) as a cardiovascular risk factor: current status. Eur Heart J. 2010;31:2844–53.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Norgren L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, Fowkes FG, Group TIW. Inter-society consensus for the management of peripheral arterial disease (TASC II). J Vasc Surg. 2007;45(Suppl S):S5–67.

    PubMed  Google Scholar 

  • Nugent AKGJ, Gorby LK, Moriarty PM. Lipoprotein apheresis: first FDA indicated treatment for elevated lipoprotein(a). J Clin Cardiol. 2020;1:16–21.

    Google Scholar 

  • Obisesan OH, Kou M, Wang FM, Boakye E, Honda Y, Uddin SMI, Dzaye O, Osei AD, Orimoloye OA, Howard-Claudio CM, Coresh J, Blumenthal RS, Hoogeveen RC, Budoff MJ, Matsushita K, Ballantyne CM, Blaha MJ. Lipoprotein(a) and subclinical vascular and valvular calcification on cardiac computed tomography: the atherosclerosis risk in communities study. J Am Heart Assoc. 2022;11:e024870.

    PubMed  PubMed Central  Google Scholar 

  • Pan YCX, Jing J, Wang S, Meng X, Mei L, Yang Y, Jin A, DongXiao Y, Li S, Li H, Wei T, Wang Y, Wang Y. Differential associations of lipoprotein(a) level with cerebral large artery and small vessel diseases. Stroke Vasc Neurol. 2022; https://doi.org/10.1136/svn-2022-001625.

  • Patel AP, Wang M, Pirruccello JP, Ellinor PT, Ng K, Kathiresan S, Khera AV. Lp(a) (Lipoprotein[a]) concentrations and incident atherosclerotic cardiovascular disease: new insights from a large national biobank. Arterioscler Thromb Vasc Biol. 2021;41:465–74.

    CAS  PubMed  Google Scholar 

  • Price JF, Lee AJ, Rumley A, Lowe GD, Fowkes FG. Lipoprotein(a) and development of intermittent claudication and major cardiovascular events in men and women: the Edinburgh Artery Study. Atherosclerosis. 2001;157:241–9.

    CAS  PubMed  Google Scholar 

  • Rasouli M, Kiasari AM, Mokhberi V. The ratio of apoB/apoAI, apoB and lipoprotein(a) are the best predictors of stable coronary artery disease. Clin Chem Lab Med. 2006;44:1015–21.

    CAS  PubMed  Google Scholar 

  • Reyes-Soffer GGH, Ramakrishnan R. The metabolism of lipoprotein(a): an ever-evolving story. J Lipid Res. 2017;58:1756–64.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Reyes-Soffer G, Ginsberg HN, Berglund L, Duell PB, Heffron SP, Kamstrup PR, Lloyd-Jones DM, Marcovina SM, Yeang C, Koschinsky ML, American Heart Association Council on Arteriosclerosis, Thrombosis and Vascular Biology, Council on Cardiovascular Radiology and Intervention, Council on Peripheral Vascular Disease. Lipoprotein(a): a genetically determined, causal, and prevalent risk factor for atherosclerotic cardiovascular disease: a scientific statement from the American Heart Association. Arterioscler Thromb Vasc Biol. 2021; https://doi.org/10.1161/ATV.0000000000000147.

  • Riches K, Porter KE. Lipoprotein(a): cellular effects and molecular mechanisms. Cholesterol. 2012;2012:923289.

    PubMed  PubMed Central  Google Scholar 

  • Ridker PM, Everett BM, Thuren T, MacFadyen JG, Chang WH, Ballantyne C, Fonseca F, Nicolau J, Koenig W, Anker SD, Kastelein JJP, Cornel JH, Pais P, Pella D, Genest J, Cifkova R, Lorenzatti A, Forster T, Kobalava Z, Vida-Simiti L, Flather M, Shimokawa H, Ogawa H, Dellborg M, Rossi PRF, Troquay RPT, Libby P, Glynn RJ, Group CT. Anti-inflammatory therapy with canakinumab for atherosclerotic disease. N Engl J Med. 2017;377:1119–31.

    CAS  PubMed  Google Scholar 

  • Rodger EJ, Porteous CM, Jones GT, Legge M, Kleffmann T, McCormick SPA. Proteomic analysis of liver from human lipoprotein(a) transgenic mice shows an oxidative stress and lipid export response. Biomed Res Int. 2018;2018:4963942.

    PubMed  PubMed Central  Google Scholar 

  • Roeseler E, Julius U, Heigl F, Spitthoever R, Heutling D, Breitenberger P, Leebmann J, Lehmacher W, Kamstrup PR, Nordestgaard BG, Maerz W, Noureen A, Schmidt K, Kronenberg F, Heibges A, Klingel R, ProLiFe-Study G. Lipoprotein apheresis for lipoprotein(a)-associated cardiovascular disease: prospective 5 years of follow-up and apolipoprotein(a) characterization. Arterioscler Thromb Vasc Biol. 2016;36:2019–27.

    CAS  PubMed  Google Scholar 

  • Saleheen D, Haycock P, Zhao W, Rasheed A, Taleb A, Imran A, Abbas S, Majeed F, Akhtar S, Qamar N, Zaman KS, Yaqoob Z, Saghir T, Rizvi SN, Memon A, Mallick NH, Ishaq M, Rasheed SZ, Memon FU, Mahmood K, Ahmed N, Frossard P, Tsimikas S, Witztum JL, Marcovina S, Sandhu M, Rader DJ, Danesh J. Apolipoprotein(a) isoform size, lipoprotein(a) concentration, and coronary artery disease: a mendelian randomisation analysis. Lancet Diabetes Endocrinol. 2017;5:524.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Sandholzer C, Saha N, Kark JD, Rees A, Jaross W, Dieplinger H, Hoppichler F, Boerwinkle E, Utermann G. Apo(a) isoforms predict risk for coronary heart disease. A study in six populations. Arterioscler Thromb. 1992;12:1214–26.

    CAS  PubMed  Google Scholar 

  • Scanu AM. Lipoprotein(a): a genetically determined lipoprotein containing a glycoprotein of the plasminogen family. Semin Thromb Hemost. 1988;14:266–70.

    CAS  PubMed  Google Scholar 

  • Schnitzler JG, Hoogeveen RM, Ali L, Prange KHM, Waissi F, van Weeghel M, Bachmann JC, Versloot M, Borrelli MJ, Yeang C, De Kleijn DPV, Houtkooper RH, Koschinsky ML, de Winther MPJ, Groen AK, Witztum JL, Tsimikas S, Stroes ESG, Kroon J. Atherogenic lipoprotein(a) increases vascular glycolysis, thereby facilitating inflammation and leukocyte extravasation. Circ Res. 2020;126:1346–59. https://pubmed.ncbi.nlm.nih.gov/35606079/.

  • Simony SB, Mortensen MB, Langsted A, Afzal S, Kamstrup PR, Nordestgaard BG. Sex differences of lipoprotein(a) levels and associated risk of morbidity and mortality by age: The Copenhagen General Population Study. Atherosclerosis. 2022;355:76–82.

    CAS  PubMed  Google Scholar 

  • Sniderman AD, Thanassoulis G, Glavinovic T, Navar AM, Pencina M, Catapano A, Ference BA. Apolipoprotein B particles and cardiovascular disease: a narrative review. JAMA Cardiol. 2019;4:1287–95.

    PubMed  PubMed Central  Google Scholar 

  • Stefanutti C, Pisciotta L, Favari E, Di Giacomo S, Vacondio F, Zenti MG, Morozzi C, Berretti D, Mesce D, Vitale M, Pasta A, Ronca A, Garuti A, Manfredini M, Angles-Cano E, Marcovina SM, Watts GF, Multidisciplinary International Group for Hemapheresis TherapY and MEDIC.ORG MEDC-M. Lipoprotein(a) concentration, genetic variants, apo(a) isoform size, and cellular cholesterol efflux in patients with elevated Lp(a) and coronary heart disease submitted or not to lipoprotein apheresis: an Italian case-control multicenter study on Lp(a). J Clin Lipidol. 2020;14:487–497.e1.

    PubMed  Google Scholar 

  • Syrovets T, Thillet J, Chapman MJ, Simmet T. Lipoprotein(a) is a potent chemoattractant for human peripheral monocytes. Blood. 1997;90:2027–36.

    CAS  PubMed  Google Scholar 

  • Tada H, Takamura M, Kawashiri MA. Lipoprotein(a) as an old and new causal risk factor of atherosclerotic cardiovascular disease. J Atheroscler Thromb. 2019;26:583–91.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Tmoyan NA, Ezhov MV, Afanasieva OI, Klesareva EA, Razova OA, Kukharchuk VV, Pokrovsky SN. The association of lipoprotein(a) and apolipoprotein(a) phenotypes with peripheral artery disease. Ter Arkh. 2018;90:31–6.

    CAS  PubMed  Google Scholar 

  • TokgözoÄŸlu L, Libby P. The dawn of a new era of targeted lipid-lowering therapies. Eur Heart J. 2022;43(34):3198–208. PMID: 35051271.

    CAS  PubMed  Google Scholar 

  • Tomoi Y, Takahara M, Soga Y, Kodama K, Imada K, Hiramori S, Ando K. Impact of high lipoprotein(a) levels on clinical outcomes following peripheral endovascular therapy. JACC Cardiovasc Interv. 2022;15:1466–76.

    PubMed  Google Scholar 

  • Tsimikas S. A test in context: lipoprotein(a): diagnosis, prognosis, controversies, and emerging therapies. J Am Coll Cardiol. 2017;69:692–711.

    CAS  PubMed  Google Scholar 

  • Tybjaerg-Hansen A. Using human genetics to predict the effects and side effects of lipoprotein(a)-lowering drugs. J Am Coll Cardiol. 2016;68:2773–5.

    PubMed  Google Scholar 

  • Utermann G. The mysteries of lipoprotein(a). Science. 1989;246:904–10.

    CAS  PubMed  Google Scholar 

  • Utermann G. Genetic architecture and evolution of the lipoprotein(a) trait. Curr Opin Lipidol. 1999;10:133–41.

    CAS  PubMed  Google Scholar 

  • van Capelleveen JC, van der Valk FM, Stroes ES. Current therapies for lowering lipoprotein(a). J Lipid Res. 2016;57:1612–8.

    PubMed  PubMed Central  Google Scholar 

  • Waldmann E, Parhofer KG. Apheresis for severe hypercholesterolaemia and elevated lipoprotein(a). Pathology. 2019;51:227–32.

    CAS  PubMed  Google Scholar 

  • Youssef A, Clark JR, Marcovina SM, Boffa MB, Koschinsky ML. Apo(a) and ApoB interact noncovalently within hepatocytes: implications for regulation of Lp(a) levels by modulation of ApoB secretion. Arterioscler Thromb Vasc Biol. 2022;42:289–304.

    CAS  PubMed  Google Scholar 

  • Zheng Z, Nakamura K, Gershbaum S, Wang X, Thomas S, Bessler M, Schrope B, Krikhely A, Liu RM, Ozcan L, Lopez JA, Tabas I. Interacting hepatic PAI-1/tPA gene regulatory pathways influence impaired fibrinolysis severity in obesity. J Clin Invest. 2020;130:4348–59.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Zhiduleva EV, Irtyuga OB, Shishkova AA, Ignat’eva EV, Kostina AS, Levchuk KA, Golovkin AS, Rylov AY, Kostareva AA, Moiseeva OM, Malashicheva AB, Gordeev ML. Cellular mechanisms of aortic valve calcification. Bull Exp Biol Med. 2018;164:371–5.

    CAS  PubMed  Google Scholar 

Download references

Author information

Author notes

  1. Anastasiya Matveyenko and Marianna Pavlyha contributed equally with all other contributors.

Authors and Affiliations

  1. Division of Preventive Medicine and Nutrition, Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA

    Anastasiya Matveyenko, Marianna Pavlyha & Gissette Reyes-Soffer

Authors
  1. Anastasiya Matveyenko
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marianna Pavlyha
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gissette Reyes-Soffer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gissette Reyes-Soffer .

Editor information

Editors and Affiliations

  1. Mater Hospital, University of Queensland, Brisbane, QLD, Australia

    Karam Kostner

  2. Medical University of Graz, Graz, Austria

    Gerhard M. Kostner

  3. Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Peter P. Toth

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Matveyenko, A., Pavlyha, M., Reyes-Soffer, G. (2023). The Role of Lp(a) in Atherosclerosis: An Overview. In: Kostner, K., Kostner, G.M., Toth, P.P. (eds) Lipoprotein(a). Contemporary Cardiology. Humana, Cham. https://doi.org/10.1007/978-3-031-24575-6_9

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-24575-6_9

  • Published:

  • Publisher Name: Humana, Cham

  • Print ISBN: 978-3-031-24574-9

  • Online ISBN: 978-3-031-24575-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation