Summary
Aim of the study. To review the general characteristics, structure and significance of Lp(a) in modern cardiology.
Methods. Search for articles using the international database PubMed. Articles published in English in the last ten years (2013-2023) were selected.
Results. Lipoprotein (a) is a plasma macromolecular complex first described and discovered in 1963 by Norwegian physician Kåre Berg. The importance of Lp(a) as a risk factor for cardiovascular disease was only appreciated more than a decade later and now an increasing number of studies are currently being conducted to evaluate its impact on the development of events. Lp(a) is a spherical lipid-protein complex consisting of a lipoprotein particle with a protein-lipid composition quite similar to LDL, to which an additional apolipoprotein called apolipoprotein (a) and apoB-100 are covalently attached. Lipoprotein (a) is covered by a layer of simple phospholipids, free cholesterol and apoproteins, with a core of triglycerides and esterified cholesterol. Plasma Lp(a) levels are mainly determined by the LPA gene (~90%), with age, sex and lifestyle factors having a minor influence. Lp(a) plays a pathogenetic role in atherosclerosis and thrombosis, and is strongly associated with heart disease caused by atherosclerosis and has long been considered a risk factor for cardiovascular disease. High levels of Lp(a) may increase the risk of cardiovascular diseases even in the absence of other classical risk factors. Lipoprotein(a) is associated with aortic valve stenosis, ischemic heart disease and peripheral artery disease.
Conclusions. A review of the literature suggests that lipoprotein (a) plays an important role in the development of atherosclerosis and thrombosis. It is an atherogenic lipoprotein whose plasma levels are 90% due to genetics, with age, gender, diet and physical activity having a minor influence. This lipoprotein is strongly associated with coronary heart disease and is considered an independent risk factor for cardiovascular disease, with high concentrations of Lp(a) increasing the risk of atherosclerotic cardiovascular disease, myocardial infarction, stroke, aortic valve stenosis, heart failure, peripheral arterial disease, while low concentrations of Lp(a) have been associated with an increased risk for type 2 diabetes mellitus.
