Lipoprotein(a) : always relevant for Indians
Journal Title: Journal of the Indian Medical Association - Year 2018, Vol 116, Issue 7
Abstract
Lipoprotein(a) [Lp(a)] comprises of an LDL-like particle consisting of apoB which is covalently bound by a disulfide bond to apolipoprotein(a) (apo[a]). Role of Lp(a) in promoting cardiovascular disease (CVD) is well-proven. Apo(a) predisposes to atherosclerosis through its three prong actions : proinflammatory, proatherogenc and prothrombotic. The “residual risk” following adequate lowering of LDL with statins is predominantly attributable to elevated Lp(a). This particularly explains the high prevalence of atherosclerotic CVD amongst Asian Indians because as many as 40% of Indian population has elevated Lp(a). Niacin and PCSK9 inhibitors are only agents with any appreciable effect on Lp(a) lowering. The newest emerging therapy in lowering Lp(a) is a group of agents called Antisense Oligonucleotides (ASO). It remains to be seen whether lowering genetically elevated Lp(a) can reduce CVD risk.
Authors and Affiliations
Ankit Roy, Arunangshu Ganguly, Soumitra Kumar
Keywords
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