Lipoprotein(a): Evidence for Role as a Causal Risk Factor in Cardiovascular Disease and Emerging Therapies

Bhatia, Harpreet

doi:10.3390/jcm11206040

Cited by 21 publications

(10 citation statements)

References 110 publications

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“…These oxidized phospholipids stimulate the production of the inflammatory proteins interleukin‐8 and monocyte chemoattractant proteins. Recent research also reveals that the pathophysiology of Lp(a) depends on this pro‐inflammatory impact 35–37 …”

Section: Discussionmentioning

confidence: 99%

“…Recent research also reveals that the pathophysiology of Lp(a) depends on this pro-inflammatory impact. [35][36][37] Regarding Lp(a) inversed relationship with AF, as Tao et al 31 suggested in a large-scale retrospective cohort study indicated that Lp(a) level lower than 32.42 mg/dL could be a potential risk factor for AF. It was interesting to note that only women showed this association.…”

Section: Referencesmentioning

confidence: 99%

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The association between lipoprotein(a) and atrial fibrillation: A systemic review and meta‐analysis

Yang

Nasr

Liu

et al. 2023

Clinical Cardiology

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Lipoprotein(a) (Lp[a]) is a particle consisting of a low‐density lipoprotein (LDL)‐like core connected to an apolipoprotein(a) chain, which is an established risk factor for cardiovascular disease. However, studies addressing the relationship between atrial fibrillation (AF) and Lp(a) demonstrated conflicted results. Thus, we sought to evaluate this relationship by conducting this systemic review and meta‐analysis. We performed a comprehensive systematic search of health science databases, including PubMed, Embase, Cochrane Library, Web of Science, MEDLINE, and ScienceDirect, to identify all relevant literature from their inception to March 1, 2023. We identified nine related articles, which were eventually included in this study. Our study showed no association between Lp(a) with new‐onset AF (HR = 1.45, 95% confidence interval [CI]: 0.57–3.67, p = .432). In addition, genetically elevated Lp(a) was not associated with the risk of atrial fibrillation (OR = 1.00, 95% CI: 1.00–1.00, p = .461). Different stratification of Lp(a) levels may have different outcomes. Also, higher Lp(a) levels may be inversely associated with the risk of developing AF compared to those with lower levels. Lp(a) levels were not associated with incident AF. Further research is needed to identify the mechanism underlying these results and better understand Lp(a) stratification for AF and the possible inverse association between Lp(a) and AF.

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Section: Discussionmentioning

confidence: 99%

Section: Referencesmentioning

confidence: 99%

The association between lipoprotein(a) and atrial fibrillation: A systemic review and meta‐analysis

Yang

Nasr

Liu

et al. 2023

Clinical Cardiology

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“…Apo(a) inhibits tissue plasminogen activator (tPA) activation of plasminogen to plasmin and plasminogen binding to fibrin but also promotes increased platelet activity. Hence it leads to thrombosis [20]. Lp(a) is positively correlated with platelet aggregation independent of lipoprotein-associated phospholipase A2 (Lp-PLA2), which may be partly responsible for the atherothrombotic effect of Lp(a).…”

Section: Pathogenicity Of Lp(a)mentioning

confidence: 99%

Lipoprotein(a)—60 Years Later—What Do We Know?

Pasławska,

Tomasik

2023

Cells

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Lipoprotein(a) (Lp(a)) molecule includes two protein components: apolipoprotein(a) and apoB100. The molecule is the main transporter of oxidized phospholipids (OxPL) in plasma. The concentration of this strongly atherogenic lipoprotein is predominantly regulated by the LPA gene expression. Lp(a) is regarded as a risk factor for several cardiovascular diseases. Numerous epidemiological, clinical and in vitro studies showed a strong association between increased Lp(a) and atherosclerotic cardiovascular disease (ASCVD), calcific aortic valve disease/aortic stenosis (CAVD/AS), stroke, heart failure or peripheral arterial disease (PAD). Although there are acknowledged contributions of Lp(a) to the mentioned diseases, clinicians struggle with many inconveniences such as a lack of well-established treatment lowering Lp(a), and common guidelines for diagnosing or assessing cardiovascular risk among both adult and pediatric patients. Lp(a) levels are different with regard to a particular race or ethnicity and might fluctuate during childhood. Furthermore, the lack of standardization of assays is an additional impediment. The review presents the recent knowledge on Lp(a) based on clinical and scientific research, but also highlights relevant aspects of future study directions that would approach more suitable and effective managing risk associated with increased Lp(a), as well as control the Lp(a) levels.

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“…Lipoprotein(a) (Lp[a]) is a lipid-carrying particle composed of an LDL-like particle containing apolipoprotein B-100 linked by a disulfide bond to apolipoprotein(a). 8 Lp(a) levels are fundamentally determined by genetic variability at the LPA locus. 9 Genetic and epidemiologic studies have shown that high levels of Lp(a) are an independent risk factor for atherosclerotic cardiovascular disease and aortic valve stenosis through mechanisms associated with increased atherogenesis, inflammation, and thrombosis.…”

Section: Introductionmentioning

confidence: 99%

Elevated Lipoprotein(a) Levels and Atrial Fibrillation: A Systematic Review

Masson,

Barbagelata,

Nogueira

et al. 2023

J Lipid Atheroscler

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Objective The role of lipoprotein(a) (Lp[a]) as a possibly causal risk factor for atherosclerotic cardiovascular disease has been well established. However, the clinical evidence regarding the association between Lp(a) levels and atrial fibrillation (AF) remains limited and inconsistent. This study aimed to analyze the association between elevated Lp(a) levels or single-nucleotide polymorphisms (SNPs) related to high levels of Lp(a) and AF. Methods This systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A literature search was performed to identify studies that evaluated the association between Lp(a) levels or SNPs related to high levels of Lp(a) and AF. Observational studies with a cross-sectional, case-control, or cohort design were included in this systematic review, without limitations according to language, country, or publication type. Results Eleven observational studies including 1,246,817 patients were eligible for this systematic review. Two cross-sectional studies, 5 prospective/retrospective cohort studies, and 4 Mendelian randomization studies were analyzed. Two cross-sectional studies that compared Lp(a) levels between patients with and without AF showed conflicting results. Cohort studies that evaluated the incidence of AF according to Lp(a) levels showed different results: no association (3 studies), a positive association (1 study), and an inverse relationship (1 study). Finally, Mendelian randomization studies also showed heterogeneous results (positive association: 2 studies; inverse association: 1 study; no association: 1 study). Conclusion Although there could be an association between Lp(a) levels and AF, the results of the studies published to date are contradictory and not yet definitive. Therefore, further research should clarify this issue.

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Lipoprotein(a): Evidence for Role as a Causal Risk Factor in Cardiovascular Disease and Emerging Therapies

Cited by 21 publications

References 110 publications

The association between lipoprotein(a) and atrial fibrillation: A systemic review and meta‐analysis

The association between lipoprotein(a) and atrial fibrillation: A systemic review and meta‐analysis

Lipoprotein(a)—60 Years Later—What Do We Know?

Elevated Lipoprotein(a) Levels and Atrial Fibrillation: A Systematic Review

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