Gustavo Saravia-Risso, Clínica San Felipe, Lima, Perú
Lipoprotein(a) [Lp(a)] is a low density lipoprotein-like lipoprotein composed of an apolipoprotein B100-containing particle covalently bound to apolipoprotein(a), with circulating levels largely determined by genetic factors. Since its initial description by Berg in 1963, epidemiological and genetic evidence has suggested elevated Lp(a) as an independent and causal risk factor for atherosclerotic cardiovascular disease. However, its clinical interpretation remains heterogeneous because of differences in measurement units, risk thresholds, ethnic distribution, test availability and the current absence of approved Lp(a)-specific therapies with proven cardiovascular outcome benefit. This review summarizes the pathophysiological, genetic, clinical and therapeutic aspects of Lp(a), with emphasis on its role as a marker of residual cardiovascular risk and on emerging targeted therapies.
Keywords: Lipoprotein(a). Cardiovascular risk. Atherosclerosis. Aortic stenosis. Cardiovascular prevention. Lipid-lowering therapy.