Lipoprotein(a): Emerging insights and therapeutics.
Lipoprotein(a): Emerging insights and therapeutics.
复制标题
脂蛋白（a）：新兴见解和治疗方法。
DOI：
10.1016/j.ajpc.2024.100641
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发表时间：
2024
影响因子：
4.1
通讯作者：
Weber,Brittany
中科院分区：
文献类型：
--
作者：
Kaur,Gurleen;Abdelrahman,Khaled;Berman,AdamN;Biery,DavidW;Shiyovich,Arthur;Huck,Daniel;Garshick,Michael;Blankstein,Ron;Weber,Brittany
脂蛋白 (a) [Lp(a)] 与动脉粥样硬化性心血管疾病 (ASCVD) 密切相关，因此人们认为它是减轻残余心血管风险的潜在目标。虽然大约 20% 的人群 Lp(a) 水平高于 50 mg/dL，但目前尚无药物降脂疗法能够显着降低 Lp(a)。降低 Lp(a) 的新疗法包括反义寡核苷酸和小干扰核糖核酸分子，并在 2 期试验中显示出有希望的结果。 3 期试验目前正在进行中，将测试 Lp(a) 与 ASCVD 之间的因果关系，以及降低 Lp(a) 是否会减少心血管结局。在这篇综述中，我们总结了与 Lp(a) 作为 ASCVD 风险增加因素的作用、与钙化性主动脉瓣狭窄的关联、现有疗法对 Lp(a) 水平的影响以及患者群体之间的差异相关的新见解。进一步讨论了新兴疗法不断发展的治疗前景。
Lipoprotein (a) [Lp(a)]’s strong association with atherosclerotic cardiovascular disease (ASCVD) has led to considerations of it being a potential target for mitigating residual cardiovascular risk. While approximately 20% of the population has an Lp(a) level greater than 50 mg/dL, there are no currently available pharmacological lipid-lowering therapies that have demonstrated substantial reduction in Lp(a). Novel therapies to lower Lp(a) include antisense oligonucleotides and small-interfering ribonucleic acid molecules and have shown promising results in phase 2 trials. Phase 3 trials are currently underway and will test the causal relationship between Lp(a) and ASCVD and whether lowering Lp(a) reduces cardiovascular outcomes. In this review, we summarize emerging insights related to Lp(a)’s role as a risk-enhancing factor for ASCVD, association with calcific aortic stenosis, effects of existing therapies on Lp(a) levels, and variations amongst patient populations. The evolving therapeutic landscape of emerging therapeutics is further discussed.