Lipoprotein(a) and ischemic stroke: current insights and knowledge gaps

Lipoprotein(a) [Lp(a)], a particle similar to low-density lipoprotein, has been consistently identified as a significant risk factor for cardiovascular disease (CVD). Emerging data from epidemiological observation and genetic studies have demonstrated that elevated levels of Lp(a), primarily influenced by genetic variation, are associated with an increased risk of ischemic strokes (IS). This association may be attributed to the proatherogenic, proinflammatory, and prothrombotic properties of Lp(a). Although therapeutic interventions specifically aimed at reducing Lp(a) levels are still under development, understanding the relationship of Lp(a) and IS could aid in the management of IS. This review aims to present the clinical evidence, pathophysiological mechanisms, and potential implications linking Lp(a) to IS, with the goal of raising awareness of Lp(a) in real-world clinical practice for IS prevention and treatment.