Despite adequate primary and secondary prevention of cardiovascular events, significant residual risk remains. Part of this risk has been attributed to lipoprotein (a) (Lpa). This is a genetically determined lipoprotein that has been linked to cardiovascular disease. Its variability and pathogenicity are attributed to the unique apolipoprotein (a) (apoa) within the molecule. This protein has been related to proatherogenic, proinflammatory, prothrombotic, and procalcific mechanisms that favor cardiovascular disease (CVD). Although it is recognized as a causal factor in disease, there are currently no approved therapeutics targeting this lipoprotein. Current management focuses on aggressive control of traditional cardiovascular risk factors. Novel therapeutics targeting Lp (a), including small interfering ribonucleic acids (siRNAs) and antisense oligonucleotides (ASOs), showed promising results in phase 2 trials. Multiple therapeutics are currently undergoing phase 3 trials, promising to bring a solution to this unsolved issue.
Sotela et al. (Fri,) studied this question.