Role of Lipoprotein(a) in Atherosclerotic Cardiovascular Disease in South Asian Individuals
South Asian individuals (SA), representing approximately one quarter of the global population, experience a disproportionately high burden of cardiovascular disease. Some of this increased susceptibility is accounted for by traditional risk factors such as diabetes, hypertension, carbohydrate‐rich d...
Saved in:
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2025-07-01
|
| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.124.040361 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849716232797814784 |
|---|---|
| author | Darshan Patel Marlys L. Koschinsky Anandita Agarwala Pradeep Natarajan Harpreet S. Bhatia Anurag Mehta Jaideep Patel Matthew Peters Shreya Pandya Usman Sagheer Raman Puri Salim S. Virani Dinesh K. Kalra |
| author_facet | Darshan Patel Marlys L. Koschinsky Anandita Agarwala Pradeep Natarajan Harpreet S. Bhatia Anurag Mehta Jaideep Patel Matthew Peters Shreya Pandya Usman Sagheer Raman Puri Salim S. Virani Dinesh K. Kalra |
| author_sort | Darshan Patel |
| collection | DOAJ |
| description | South Asian individuals (SA), representing approximately one quarter of the global population, experience a disproportionately high burden of cardiovascular disease. Some of this increased susceptibility is accounted for by traditional risk factors such as diabetes, hypertension, carbohydrate‐rich diets, and rising rates of obesity and metabolic syndrome. However, other previously underappreciated risk factors may also play a crucial role. These include environmental pollution, genetic factors, and Lp(a) (lipoprotein(a)). Various epidemiological and genetic studies support the role of Lp(a) as a causal and independent risk factor for atherosclerotic cardiovascular disease. SA have a higher prevalence of elevated Lp(a) levels (25% have levels >50 mg/dL) compared with Western populations, and this may be one factor that accounts for the earlier age of onset of coronary artery disease, its more aggressive course, and higher morbidity and mortality in this group. SA experience myocardial infarction nearly 10 years earlier than individuals of European descent and have higher rates of premature and multivessel coronary artery disease. Additionally, socioeconomic shifts, cultural practices, and disparities in health care access may further exacerbate these risks, creating a complex interplay of factors that heighten cardiovascular vulnerability in SA. In this article, we review the data on the role of Lp(a) in mediating atherosclerotic cardiovascular disease, its epidemiology in SA, current screening guidelines, and drugs in the pipeline that will potentially be able to reduce high Lp(a) levels and associated cardiovascular risk. Ultimately, outcome trials with such drugs will be needed in this large population to examine their efficacy and safety. |
| format | Article |
| id | doaj-art-d78a68261aaa478ca4f40e49674e0f2c |
| institution | DOAJ |
| issn | 2047-9980 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-d78a68261aaa478ca4f40e49674e0f2c2025-08-20T03:13:04ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-07-01141410.1161/JAHA.124.040361Role of Lipoprotein(a) in Atherosclerotic Cardiovascular Disease in South Asian IndividualsDarshan Patel0Marlys L. Koschinsky1Anandita Agarwala2Pradeep Natarajan3Harpreet S. Bhatia4Anurag Mehta5Jaideep Patel6Matthew Peters7Shreya Pandya8Usman Sagheer9Raman Puri10Salim S. Virani11Dinesh K. Kalra12Division of Cardiology University of Louisville Louisville KY USARobarts Research Institute and the Department of Physiology and Pharmacology Western University London Ontario CanadaCenter for Cardiovascular Disease Prevention, Baylor Scott and White The Heart Hospital Baylor Plano Plano TX USACenter for Genomic Medicine and Cardiovascular Research Center Massachusetts General Hospital Boston MA USADivision of Cardiovascular Medicine University of California San Diego La Jolla CA USAVCU Health Pauley Heart Center Virginia Commonwealth University Richmond VA USASouth Asian Cardiovascular Health Initiative (SACHI), Johns Hopkins Ciccarone for the Center of Prevention of Cardiovascular Disease Johns Hopkins Hospital Baltimore MD USADivision of Cardiology University of Louisville Louisville KY USADivision of Cardiology University of Louisville Louisville KY USADivision of Cardiology University of Louisville Louisville KY USACardiac Care Centre Indraprastha Apollo Hospital New Delhi IndiaThe Aga Khan University Karachi PakistanDivision of Cardiology University of Louisville Louisville KY USASouth Asian individuals (SA), representing approximately one quarter of the global population, experience a disproportionately high burden of cardiovascular disease. Some of this increased susceptibility is accounted for by traditional risk factors such as diabetes, hypertension, carbohydrate‐rich diets, and rising rates of obesity and metabolic syndrome. However, other previously underappreciated risk factors may also play a crucial role. These include environmental pollution, genetic factors, and Lp(a) (lipoprotein(a)). Various epidemiological and genetic studies support the role of Lp(a) as a causal and independent risk factor for atherosclerotic cardiovascular disease. SA have a higher prevalence of elevated Lp(a) levels (25% have levels >50 mg/dL) compared with Western populations, and this may be one factor that accounts for the earlier age of onset of coronary artery disease, its more aggressive course, and higher morbidity and mortality in this group. SA experience myocardial infarction nearly 10 years earlier than individuals of European descent and have higher rates of premature and multivessel coronary artery disease. Additionally, socioeconomic shifts, cultural practices, and disparities in health care access may further exacerbate these risks, creating a complex interplay of factors that heighten cardiovascular vulnerability in SA. In this article, we review the data on the role of Lp(a) in mediating atherosclerotic cardiovascular disease, its epidemiology in SA, current screening guidelines, and drugs in the pipeline that will potentially be able to reduce high Lp(a) levels and associated cardiovascular risk. Ultimately, outcome trials with such drugs will be needed in this large population to examine their efficacy and safety.https://www.ahajournals.org/doi/10.1161/JAHA.124.040361atherosclerosiscardiovascular riskethnicitylipoprotein(a)South Asian people |
| spellingShingle | Darshan Patel Marlys L. Koschinsky Anandita Agarwala Pradeep Natarajan Harpreet S. Bhatia Anurag Mehta Jaideep Patel Matthew Peters Shreya Pandya Usman Sagheer Raman Puri Salim S. Virani Dinesh K. Kalra Role of Lipoprotein(a) in Atherosclerotic Cardiovascular Disease in South Asian Individuals Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease atherosclerosis cardiovascular risk ethnicity lipoprotein(a) South Asian people |
| title | Role of Lipoprotein(a) in Atherosclerotic Cardiovascular Disease in South Asian Individuals |
| title_full | Role of Lipoprotein(a) in Atherosclerotic Cardiovascular Disease in South Asian Individuals |
| title_fullStr | Role of Lipoprotein(a) in Atherosclerotic Cardiovascular Disease in South Asian Individuals |
| title_full_unstemmed | Role of Lipoprotein(a) in Atherosclerotic Cardiovascular Disease in South Asian Individuals |
| title_short | Role of Lipoprotein(a) in Atherosclerotic Cardiovascular Disease in South Asian Individuals |
| title_sort | role of lipoprotein a in atherosclerotic cardiovascular disease in south asian individuals |
| topic | atherosclerosis cardiovascular risk ethnicity lipoprotein(a) South Asian people |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.124.040361 |
| work_keys_str_mv | AT darshanpatel roleoflipoproteinainatheroscleroticcardiovasculardiseaseinsouthasianindividuals AT marlyslkoschinsky roleoflipoproteinainatheroscleroticcardiovasculardiseaseinsouthasianindividuals AT ananditaagarwala roleoflipoproteinainatheroscleroticcardiovasculardiseaseinsouthasianindividuals AT pradeepnatarajan roleoflipoproteinainatheroscleroticcardiovasculardiseaseinsouthasianindividuals AT harpreetsbhatia roleoflipoproteinainatheroscleroticcardiovasculardiseaseinsouthasianindividuals AT anuragmehta roleoflipoproteinainatheroscleroticcardiovasculardiseaseinsouthasianindividuals AT jaideeppatel roleoflipoproteinainatheroscleroticcardiovasculardiseaseinsouthasianindividuals AT matthewpeters roleoflipoproteinainatheroscleroticcardiovasculardiseaseinsouthasianindividuals AT shreyapandya roleoflipoproteinainatheroscleroticcardiovasculardiseaseinsouthasianindividuals AT usmansagheer roleoflipoproteinainatheroscleroticcardiovasculardiseaseinsouthasianindividuals AT ramanpuri roleoflipoproteinainatheroscleroticcardiovasculardiseaseinsouthasianindividuals AT salimsvirani roleoflipoproteinainatheroscleroticcardiovasculardiseaseinsouthasianindividuals AT dineshkkalra roleoflipoproteinainatheroscleroticcardiovasculardiseaseinsouthasianindividuals |