Lipoprotein (a) Screening, and What's Next?

Lipoprotein (a) (Lp(a)) is a low-density lipoprotein (LDL) in which the apolipoprotein B100 molecule is bound to a highly polymorphic, plasminogen-like apolipoprotein (a). The concentration of Lp(a) is predominantly genetically determined, governed by the expression of the LPA gene, and remains rela...

Full description

Saved in:
Bibliographic Details
Main Authors: Pasławska Anna, Radom Agnieszka, Tomasik Przemysław
Format: Article
Language:English
Published: Sciendo 2024-12-01
Series:Journal of Cardiovascular Emergencies
Subjects:
Online Access:https://doi.org/10.2478/jce-2024-0022
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850283738186907648
author Pasławska Anna
Radom Agnieszka
Tomasik Przemysław
author_facet Pasławska Anna
Radom Agnieszka
Tomasik Przemysław
author_sort Pasławska Anna
collection DOAJ
description Lipoprotein (a) (Lp(a)) is a low-density lipoprotein (LDL) in which the apolipoprotein B100 molecule is bound to a highly polymorphic, plasminogen-like apolipoprotein (a). The concentration of Lp(a) is predominantly genetically determined, governed by the expression of the LPA gene, and remains relatively stable from early adulthood. The physiological function of Lp(a) is unknown. Lp(a) is recognized as a main carrier of oxidized phospholipids and has strong atherogenic, prothrombotic, and pro-inflammatory properties. Elevated levels of Lp(a) above 75 nmol/l (30 mg/dl) are an independent risk factor for cardiovascular diseases. According to the recommendations of the Polish Lipid Association, Lp(a) should be measured once in a lifetime. This study presents an analysis of the results of Lp(a) screening among adult patients from southeastern Poland (Nowy Sącz county) and evaluates further diagnostic and therapeutic measures for patients with elevated Lp(a) levels. Among the 231 patients screened, 48 individuals (20.8%) had increased Lp(a) levels above 75 nmol/l. Patients with elevated Lp(a) concentration were invited to participate in a survey, in which 31 individuals ultimately took part. Of these, 4 individuals were classified into the moderate risk group, 25 into the high-risk group, and 2 into the very high-risk group for cardiovascular diseases. The pharmacotherapy directly targeting the reduction of Lp(a) is currently undergoing clinical trials. Its effectiveness in decreasing Lp(a) concentrations, along with demonstrating desirable and positive effects on cardiovascular disease outcomes, requires further investigation due to the lack of conclusive evidence. Diet and physical activity have limited impact on Lp(a) concentration. It is recommended to expand preventive programs, including for younger populations, which could help identify patients with genetically determined cardiovascular risk. Additionally, there is a necessity to educate the medical personnel and patients about the significance of Lp(a) and the implementation of guidelines for managing patients with elevated Lp(a) levels.
format Article
id doaj-art-34f3d4ed8e744d30b77fb2b4671ba31b
institution OA Journals
issn 2457-5518
language English
publishDate 2024-12-01
publisher Sciendo
record_format Article
series Journal of Cardiovascular Emergencies
spelling doaj-art-34f3d4ed8e744d30b77fb2b4671ba31b2025-08-20T01:47:44ZengSciendoJournal of Cardiovascular Emergencies2457-55182024-12-0110414215010.2478/jce-2024-0022Lipoprotein (a) Screening, and What's Next?Pasławska Anna0Radom Agnieszka1Tomasik Przemysław2Centrum Zdrowia Tuchów sp. z o.o., Medical Diagnostic Laboratory,PolandDiagmed sp. z o.o., Medical Diagnostic Laboratory,PolandDepartment of Clinical Biochemistry, Institute of Pediatrics, Jagiellonian University Medical College, Kraków, PolandLipoprotein (a) (Lp(a)) is a low-density lipoprotein (LDL) in which the apolipoprotein B100 molecule is bound to a highly polymorphic, plasminogen-like apolipoprotein (a). The concentration of Lp(a) is predominantly genetically determined, governed by the expression of the LPA gene, and remains relatively stable from early adulthood. The physiological function of Lp(a) is unknown. Lp(a) is recognized as a main carrier of oxidized phospholipids and has strong atherogenic, prothrombotic, and pro-inflammatory properties. Elevated levels of Lp(a) above 75 nmol/l (30 mg/dl) are an independent risk factor for cardiovascular diseases. According to the recommendations of the Polish Lipid Association, Lp(a) should be measured once in a lifetime. This study presents an analysis of the results of Lp(a) screening among adult patients from southeastern Poland (Nowy Sącz county) and evaluates further diagnostic and therapeutic measures for patients with elevated Lp(a) levels. Among the 231 patients screened, 48 individuals (20.8%) had increased Lp(a) levels above 75 nmol/l. Patients with elevated Lp(a) concentration were invited to participate in a survey, in which 31 individuals ultimately took part. Of these, 4 individuals were classified into the moderate risk group, 25 into the high-risk group, and 2 into the very high-risk group for cardiovascular diseases. The pharmacotherapy directly targeting the reduction of Lp(a) is currently undergoing clinical trials. Its effectiveness in decreasing Lp(a) concentrations, along with demonstrating desirable and positive effects on cardiovascular disease outcomes, requires further investigation due to the lack of conclusive evidence. Diet and physical activity have limited impact on Lp(a) concentration. It is recommended to expand preventive programs, including for younger populations, which could help identify patients with genetically determined cardiovascular risk. Additionally, there is a necessity to educate the medical personnel and patients about the significance of Lp(a) and the implementation of guidelines for managing patients with elevated Lp(a) levels.https://doi.org/10.2478/jce-2024-0022lipoprotein (a)apolipoprotein (a)cardiovascular diseasesatherosclerosislipid disorders
spellingShingle Pasławska Anna
Radom Agnieszka
Tomasik Przemysław
Lipoprotein (a) Screening, and What's Next?
Journal of Cardiovascular Emergencies
lipoprotein (a)
apolipoprotein (a)
cardiovascular diseases
atherosclerosis
lipid disorders
title Lipoprotein (a) Screening, and What's Next?
title_full Lipoprotein (a) Screening, and What's Next?
title_fullStr Lipoprotein (a) Screening, and What's Next?
title_full_unstemmed Lipoprotein (a) Screening, and What's Next?
title_short Lipoprotein (a) Screening, and What's Next?
title_sort lipoprotein a screening and what s next
topic lipoprotein (a)
apolipoprotein (a)
cardiovascular diseases
atherosclerosis
lipid disorders
url https://doi.org/10.2478/jce-2024-0022
work_keys_str_mv AT pasławskaanna lipoproteinascreeningandwhatsnext
AT radomagnieszka lipoproteinascreeningandwhatsnext
AT tomasikprzemysław lipoproteinascreeningandwhatsnext