ANALYSIS OF VARIATIONS OF LP(A) LEVELS AS A BIOMARKER OF CARDIOVASCULAR DISEASES IN VARIOUS POPULATIONS

Abstract

Elevated lipoprotein(a) plasma concentration - [Lp(a)] is considered a risk factor for cardiovascular disease (CVD). In African Americans (AA) have 2-3 times above [Lp(a)] than in Europeans and Asians, for example, in Chinese - 7.0 mg/dl, in black Sudanese - 46 mg/dl. Some authors believe that the apo(a) gene is the main determinant of the [Lp(a)] variation in AA, while others recognize the role of variant factors. The relationship between [Lp(a)] and the risk of CVD in AA is unclear: in meta-analysis under the Collaboration Emerging Risk Factors, at Europeans [Lp(a)] is associated with coronary artery disease, in AA - no. In Novosibirsk, from 96 men with confirmed surgically expressed coronary atherosclerosis [Lp(a)] is raised only in 16 %, and the high-atherogenous phenotype of apo(a) was detected in 20 %; but in the presence of unstable plaques (UP) in coronary arteries [Lp(a)] is 1.8 times higher than in persons without UP. Average [Lp(a)]+ ([Лп(а)]>0) at Chukchi male made 28,1 mg/dl, Chukchi female have 28,4 mg/dl, at Eskimos with [Lp(a)]+ the median of the [Lp(a)] - 22,4 mg/dl, and the mode - 15,5 mg/dl. In the aboriginals of Chukotka with AH, apo(a) S1, S2 occurred a little more frequently than among those without AH. Along with lipoprotein apheresis and niacin, apolipoprotein-(B-100)-antisense mipomersen, inhibitor of PCSK9 and apolipoprotein-(a)-antisense (oligonucleotide), showed promising results in reducing [Lp(a)]. In Russia, ehvolocumab and alirocoumab have been approved.

Keywords

• lipoprotein(a)
• apolipoprotein(a)
• cardiovascular risk
• african-americans
• europeans
• asians
• aboriginals of chukotka