Lipoprotein(a): An independent, genetic, and causal factor for cardiovascular disease and acute myocardial infarction

Enas A. Enas, Basil Varkey, Thiruvinvamalai S. Dharmarajan, Guillaume Pare, Vinay K. Bahl

Research output: Contribution to journalReview article

1 Citation (Scopus)

Abstract

Lipoprotein(a) [Lp(a)] is a circulating lipoprotein, and its level is largely determined by variation in the Lp(a) gene (LPA) locus encoding apo(a). Genetic variation in the LPA gene that increases Lp(a) level also increases coronary artery disease (CAD) risk, suggesting that Lp(a) is a causal factor for CAD risk. Lp(a) is the preferential lipoprotein carrier for oxidized phospholipids (OxPL), a proatherogenic and proinflammatory biomarker. Lp(a) adversely affects endothelial function, inflammation, oxidative stress, fibrinolysis, and plaque stability, leading to accelerated atherothrombosis and premature CAD. The INTER-HEART Study has established the usefulness of Lp(a) in assessing the risk of acute myocardial infarction in ethnically diverse populations with South Asians having the highest risk and population attributable risk. The 2018 Cholesterol Clinical Practice Guideline have recognized elevated Lp(a) as an atherosclerotic cardiovascular disease risk enhancer for initiating or intensifying statin therapy.

Original languageEnglish (US)
JournalIndian Heart Journal
DOIs
StatePublished - Jan 1 2019

Fingerprint

Lipoprotein(a)
Cardiovascular Diseases
Myocardial Infarction
Coronary Artery Disease
Lipoproteins
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Fibrinolysis
Practice Guidelines
Population
Genes
Phospholipids
Oxidative Stress
Biomarkers
Cholesterol
Inflammation

Keywords

  • Acute myocardial infarction
  • Cardiovascular disease
  • Genetic risk factor
  • Genome-wide association studies
  • Indians
  • Isoforms
  • Kringles
  • Lipoprotein(a)
  • Mendelian randomization
  • meta-analysis
  • Oxidized phospholipids
  • Premature coronary artery disease
  • Single nucleotide polymorphism

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Lipoprotein(a) : An independent, genetic, and causal factor for cardiovascular disease and acute myocardial infarction. / Enas, Enas A.; Varkey, Basil; Dharmarajan, Thiruvinvamalai S.; Pare, Guillaume; Bahl, Vinay K.

In: Indian Heart Journal, 01.01.2019.

Research output: Contribution to journalReview article

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AU - Varkey, Basil

AU - Dharmarajan, Thiruvinvamalai S.

AU - Pare, Guillaume

AU - Bahl, Vinay K.

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AB - Lipoprotein(a) [Lp(a)] is a circulating lipoprotein, and its level is largely determined by variation in the Lp(a) gene (LPA) locus encoding apo(a). Genetic variation in the LPA gene that increases Lp(a) level also increases coronary artery disease (CAD) risk, suggesting that Lp(a) is a causal factor for CAD risk. Lp(a) is the preferential lipoprotein carrier for oxidized phospholipids (OxPL), a proatherogenic and proinflammatory biomarker. Lp(a) adversely affects endothelial function, inflammation, oxidative stress, fibrinolysis, and plaque stability, leading to accelerated atherothrombosis and premature CAD. The INTER-HEART Study has established the usefulness of Lp(a) in assessing the risk of acute myocardial infarction in ethnically diverse populations with South Asians having the highest risk and population attributable risk. The 2018 Cholesterol Clinical Practice Guideline have recognized elevated Lp(a) as an atherosclerotic cardiovascular disease risk enhancer for initiating or intensifying statin therapy.

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