Case report of male child with elevated lipoprotein (a) leading to acute ischemic stroke

Moriarty, Patrick M.; Tennant, Heather; Sehar, N.; Denney, Lauryn; Luna, Paola; Perez-Marques, Francesca; Panchal, Apurva; Abraham, Michael; Leever, John

doi:10.1002/jca.21525

Cited by 9 publications

(7 citation statements)

References 24 publications

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“…Apart from implementing secondary stroke prevention protocols, management included lipoprotein apheresis in the first case and administration of nicotinic acid in the second to reduce Lp(a). 53,54 Data concerning stroke during the perinatal and neonatal period are intriguing. A French cohort study supported the hypothesis that an elevated maternal Lp(a) level increases the risk of neonatal AIS.…”

Section: Lp(a) and Cerebrovascular Events In Pediatric Patientsmentioning

confidence: 99%

Lipoprotein (a) and cerebrovascular disease

Kosmas,

Bousvarou,

Papakonstantinou

et al. 2024

J Int Med Res

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The role of lipoprotein (a) [Lp(a)] in cerebrovascular disease is a topic of importance. In this narrative review, pertinent studies have been leveraged to comprehensively examine this relationship from diverse perspectives. Lp(a) shares structural traits with low-density lipoprotein cholesterol. Lp(a) is synthesized by hepatocytes, and its plasma levels are genetically determined by the LPA gene, which produces apolipoprotein (a). Numerous epidemiological studies have confirmed the positive correlation between elevated serum Lp(a) levels and the occurrence or recurrence of cerebrovascular events, especially ischemic strokes, in adults. It should be noted that the correlation strength varies among studies and is marginal in Mendelian randomization studies. Regarding pediatric patients, screening is currently limited to those with a relevant medical history. Lp(a) seems to play a significant role in the pathogenesis of arterial ischemic stroke in children because environmental thrombotic and atherogenic factors are generally not present. Phase 3 trials of novel Lp(a) targeting agents, such as pelacarsen and olpasiran, are anticipated to demonstrate their efficacy in reducing the incidence of stroke. Given the richness of the literature, new guidelines regarding Lp(a) screening and management in targeted populations are warranted to provide more effective primary and secondary prevention.

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Section: Lp(a) and Cerebrovascular Events In Pediatric Patientsmentioning

confidence: 99%

Lipoprotein (a) and cerebrovascular disease

Kosmas,

Bousvarou,

Papakonstantinou

et al. 2024

J Int Med Res

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“… 142 Children with high Lp(a) levels have a 4-fold risk of ischemic stroke with an even higher risk for recurrent stroke. 143 , 144 , 145 The ischemic stroke risk is increased as high as 10-fold in those with Lp(a) > 90 th percentile. 140 …”

Section: Lp(a) and Non-coronary Diseasesmentioning

confidence: 99%

“…An 11-year old boy presented with multiple thrombotic strokes secondary to elevated Lp(a) as the only identified risk factor and was treated promptly with lipoprotein apheresis (LA). 144 Eighteen months poststroke, he is still receiving LA treatments and has made remarkable progress in his recovery without another cerebrovascular event. 144 In the United States, <50 patients with progressive CAD and elevated Lp(a) are receiving LA therapy compared with >1500 patients in Germany.…”

Section: Management Strategies For Elevated Lp(a)mentioning

confidence: 99%

“… 144 Eighteen months poststroke, he is still receiving LA treatments and has made remarkable progress in his recovery without another cerebrovascular event. 144 In the United States, <50 patients with progressive CAD and elevated Lp(a) are receiving LA therapy compared with >1500 patients in Germany. 196 Apheresis is expensive, burdensome, and unavailable in most countries.…”

Section: Management Strategies For Elevated Lp(a)mentioning

confidence: 99%

See 1 more Smart Citation

Lipoprotein(a): An independent, genetic, and causal factor for cardiovascular disease and acute myocardial infarction

Enas¹,

Varkey

Dharmarajan

et al. 2019

Indian Heart Journal

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Lipoprotein(a) [Lp(a)] is a circulating lipoprotein, and its level is largely determined by variation in the Lp(a) gene (LPA) locus encoding apo(a). Genetic variation in the LPA gene that increases Lp(a) level also increases coronary artery disease (CAD) risk, suggesting that Lp(a) is a causal factor for CAD risk. Lp(a) is the preferential lipoprotein carrier for oxidized phospholipids (OxPL), a proatherogenic and proinflammatory biomarker. Lp(a) adversely affects endothelial function, inflammation, oxidative stress, fibrinolysis, and plaque stability, leading to accelerated atherothrombosis and premature CAD. The INTER-HEART Study has established the usefulness of Lp(a) in assessing the risk of acute myocardial infarction in ethnically diverse populations with South Asians having the highest risk and population attributable risk. The 2018 Cholesterol Clinical Practice Guideline have recognized elevated Lp(a) as an atherosclerotic cardiovascular disease risk enhancer for initiating or intensifying statin therapy.

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“…Несмотря на достаточно редкую встречаемость ИИ у детей, связь с данной патологией показана в нескольких исследованиях и мета-анализах [55,56]. Проведение процедур афереза липопротеидов или прием препаратов никотиновой кислоты у детей с острым ИИ приводит к положительным клиническим результатам на фоне снижения Лп(а) [57,58].…”

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Hyperlipoproteinemia(a) as a dangerous genetically determined violation of lipid metabolism and a risk factor for atherothrombosis and cardiovascular diseases

Афанасьева

Покровский

2019

Russ J Cardiol

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Липопротеид(а) (Лп(а)) представляет собой сложный надмолекулярный комплекс, принадлежащий к апоВ 100-содержащим липопротеидам. Лп(а) состоит из частицы подобной липопротеидам низкой плотности, в которой молекула апобелка В 100 ковалентно связана дисульфидной связью с уникальной полиморфной молекулой апобелка(а). Концентрация Лп(а) генетически контролируется, при этом варьирует в очень широком диапазоне. Повышенный уровень Лп(а) является независимым фактором риска атеросклероза коронарных, сонных и периферических артерий, ишемической болезни сердца и стеноза аортального клапана, сопутствующих сердечно-сосудистых осложнений, а также осложнений после операций реваскуляризации миокарда. Несмотря на это, уровень Лп(а) по-прежнему не учитывается в стратификации риска сердечно-сосудистых заболеваний. Отчасти это может быть связано с тем, что ни современная лекарственная терапия, ни новые поколения биологических гиполипидемических препаратов практически не влияют на концентрацию Лп(а), за исключением 20-30% снижения Лп(а) никотиновой кислотой и ингибиторами пропротеиновой конвертазы субтилизин-кексин 9 типа (PCSK9). Обзор освещает современные представления о Лп(а) как факторе риска сердечно-сосудистых заболеваний, возможности и целесообразности его определения, а также посвящен современным возможностям коррекции гиперлипопротеидемии(а).

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Case report of male child with elevated lipoprotein (a) leading to acute ischemic stroke

Cited by 9 publications

References 24 publications

Lipoprotein (a) and cerebrovascular disease

Lipoprotein (a) and cerebrovascular disease

Lipoprotein(a): An independent, genetic, and causal factor for cardiovascular disease and acute myocardial infarction

Hyperlipoproteinemia(a) as a dangerous genetically determined violation of lipid metabolism and a risk factor for atherothrombosis and cardiovascular diseases

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