کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
5619108 1406054 2016 7 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
ReviewLp(a) and cardiovascular risk: Investigating the hidden side of the moon
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی کاردیولوژی و پزشکی قلب و عروق
پیش نمایش صفحه اول مقاله
ReviewLp(a) and cardiovascular risk: Investigating the hidden side of the moon
چکیده انگلیسی


- Lipoprotein (a) (Lp[a]) significantly influences the risk of cardiovascular events.
- Lp(a) seems to increase CV risk through stimulation of platelet aggregation, inhibition of tissue factor pathway inhibitor, alteration of fibrin clot structure and promotion of endothelial dysfunction and phospholipid oxidation.
- The treatment of choice for high levels of Lp(a) in high CV risk patients is represented by LDL-Apheresis.

AimsThis article reports current evidence on the association between Lp(a) and cardiovascular (CV) disease and on pathophysiological mechanisms. The available information on therapy for reduction of lipoprotein(a) is also discussed.Data synthesisAlthough some evidence is conflicting, Lp(a) seems to increase CV risk through stimulation of platelet aggregation, inhibition of tissue factor pathway inhibitor, alteration of fibrin clot structure and promotion of endothelial dysfunction and phospholipid oxidation. Lp(a) 3.5-fold higher than normal increases the risk of coronary heart disease and general CV events, particularly in those with LDL cholesterol ≥ 130 mg/dl. High Lp(a) values represent also an independent risk factor for ischemic stroke (more relevant in young stroke patients), peripheral artery disease (PAD) and aortic and mitral stenosis. Furthermore, high Lp(a) levels seem to be associated with increased risk of cardiovascular events in patients with chronic kidney disease, particularly in those undergoing percutaneous coronary intervention.ConclusionsLipoprotein (a) (Lp[a]) seems to significantly influence the risk of cardiovascular events. The effects of statins and fibrates on Lp(a) are limited and extremely variable. Nicotinic acid was shown effective in reducing Lp(a) but, due to its side effects and serious adverse events during clinical trials, it is no longer considered a possible option for treatment. To date, the treatment of choice for high levels of Lp(a) in high CV risk patients is represented by LDL-Apheresis. Thanks to innovative technologies, new selectively inhibiting LPA drugs are being developed and tested.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Nutrition, Metabolism and Cardiovascular Diseases - Volume 26, Issue 11, November 2016, Pages 980-986
نویسندگان
, , , ,