Lipoprotein(a): A Genetically Determined, Causal, and Prevalent Risk Factor for Atherosclerotic Cardiovascular Disease: A Scientific Statement from the American Heart Association

Gissette Reyes-Soffer, Henry N. Ginsberg, Lars Berglund, P. Barton Duell, Sean P. Heffron, Pia R. Kamstrup, Donald M. Lloyd-Jones, Santica M. Marcovina, Calvin Yeang, Marlys L. Koschinsky

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

High levels of lipoprotein(a) [Lp(a)], an apoB100-containing lipoprotein, are an independent and causal risk factor for atherosclerotic cardiovascular diseases through mechanisms associated with increased atherogenesis, inflammation, and thrombosis. Lp(a) is predominantly a monogenic cardiovascular risk determinant, with ≈70% to ≥90% of interindividual heterogeneity in levels being genetically determined. The 2 major protein components of Lp(a) particles are apoB100 and apolipoprotein(a). Lp(a) remains a risk factor for cardiovascular disease development even in the setting of effective reduction of plasma low-density lipoprotein cholesterol and apoB100. Despite its demonstrated contribution to atherosclerotic cardiovascular disease burden, we presently lack standardization and harmonization of assays, universal guidelines for diagnosing and providing risk assessment, and targeted treatments to lower Lp(a). There is a clinical need to understand the genetic and biological basis for variation in Lp(a) levels and its relationship to disease in different ancestry groups. This scientific statement capitalizes on the expertise of a diverse basic science and clinical workgroup to highlight the history, biology, pathophysiology, and emerging clinical evidence in the Lp(a) field. Herein, we address key knowledge gaps and future directions required to mitigate the atherosclerotic cardiovascular disease risk attributable to elevated Lp(a) levels.

Original languageEnglish (US)
Pages (from-to)E48-E60
JournalArteriosclerosis, Thrombosis, and Vascular Biology
Volume42
Issue number1
DOIs
StatePublished - Jan 1 2022

Keywords

  • AHA Scientific Statements
  • Apolipoprotein B100
  • Atherosclerotic cardiovascular disease
  • Cholesterol
  • Lipoprotein(a)
  • Low-density lipoprotein

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint

Dive into the research topics of 'Lipoprotein(a): A Genetically Determined, Causal, and Prevalent Risk Factor for Atherosclerotic Cardiovascular Disease: A Scientific Statement from the American Heart Association'. Together they form a unique fingerprint.

Cite this