Lipoproteïne(a) als cardiovasculaire risicofactor

Conflict of interest: none declared. Financial support: none declared.

• Lipoprotein a (Lp(a)) is a strongly genetically determined lipoprotein that resembles in density and size a low-density lipoprotein particle (LDL) to which apolipoprotein (a) is bound. There are several isoforms of Lp(a).

• There is strong evidence that Lp(a) is an independent risk factor for atherosclerosis and cardiovascular disease.

• Lp(a) is involved in the pathogenesis of atherosclerosis and has prothrombotic properties.

• Differences in isoform size and lack of standardization have complicated measurement of Lp(a). Currently, reliable determination of Lp(a) is possible with isoform-independent assays.

• At present the only options to lower Lp(a) levels are nicotinic acid and Lp(a) apheresis. New drugs with Lp(a)-lowering potential are being developed.

• There is no evidence from trials as yet that reducing Lp(a) levels decreases cardiovascular risk.

• Currently the clinical value of Lp(a) as a cardiovascular risk factor is limited. Lp(a) measurement could be of value in selected patient populations.