The prognostic role of lipoprotein(a) in cardiovascular disease

Lipoprotein(a) (Lp(a)), is not a new entity; however, it has become an increasingly discussed and studied risk factor for atherosclerotic cardiovascular disease (CVD) and aortic valve stenosis. Recent guidelines recommend measuring Lp(a) levels throughout the lifetime in patients at high risk for CVD, as Lp(a) can serve as a signature marker for identifying individuals at elevated risk for CVD. Numerous genetic and epidemiological studies have underscored the significant causal role of Lp(a) in the incidence of CVD. Individuals with high Lp(a) levels face an increased risk for CVD, even with optimal low-density lipoprotein cholesterol lowering. Furthermore, Lp(a) levels are primarily determined by genetics and are not significantly reduced by lifestyle changes or certain medications. This review will discuss the characteristics, genetic factors, and epidemiological properties of Lp(a) in relation to CVD.