Lipoprotein(a) as underestimated cardiovascular risk factor in Russia. Time to introduce into clinical practice

Abstract

An increased concentration of lipoprotein(a) (Lp(a)) is one of the main genetic residual risk factors for atherosclerotic cardiovascular diseases, as well as their complications. Lp(a) is a complex supramolecular complex in which the unique glycosylated apo(a) protein, which has a wide polymorphism, is linked by a disulfide bond to the apoB100 molecule (protein component of the low-density lipoprotein (LDL) particle). Therefore, Lp(a) is often called LDL-like particle. Unlike all other lipoproteins, Lp(a) concentration is determined genetically, almost constant throughout the life, and has wide individual and interethnic variability. As an independent risk factor, elevated Lp(a) concentrations can significantly increase global cardiovascular risk, especially in patients with other risk factors. Modern international and national guidelines recommend measuring Lp(a) concentration not only in certain categories of patients, but also in every person at least once in their life for a correct assessment of cardiovascular risk.

Keywords

• lipoprotein(a)
• atherosclerosis
• cardiovascular risk
• atherosclerotic cardiovascular diseases
• coronary artery disease
• clinical guidelines