The Impact of Lipoprotein (A) on Autoinflammation and its Significance in Cardiogeriatrics
https://doi.org/10.37586/2686-8636-4-2024-335-341
Abstract
Lipoprotein (а) is able to initiate mechanisms of inflammation and create an atherogenic and thrombophilic condition due to its structural features. It is important to acknowledge that there are currently no standardized protocols for the regular monitoring of lipoprotein (а) levels in clinical settings, despite its relevance in assessing cardiovascular risk among older patients. Even in the absence of abnormal lipid profiles, there may still be thickening of the arterial walls and the formation of atherosclerotic plaque. The extent of atherogenicity, or plaque development, is directly linked to plasma levels of lipoprotein (а), which have a genetic basis.
This paper aims to review the role of lipoprotein (а) in low-grade inflammation and its pathogenic mechanisms in atherosclerosis, particularly in relation to elevated levels of this lipoprotein. The study will critically analyze the available literature on this topic to understand the potential role of lipoprotein (а) as a risk factor for atherosclerosis.
About the Authors
E. V. KorotkovaRussian Federation
Korotkova Elena Vladimirovna,
Saint Petersburg.
ResearcherID: IAO-5719-2023
A. V. Zavyalov
Russian Federation
Zavyalov Andrew Vasil'evich,
Saint Petersburg.
A. Yu. Kovalenko
Russian Federation
Kovalenko Angelina Yurievna,
Saint Petersburg.
References
1. Ежов М.В., Кухарчук В.В., Сергиенко И.В., и др. Нарушения липидного обмена. Клинические рекомендации 2023 // Российский кардиологический журнал. 2023. Т. 28. № 5. С. 250–297. [Ezhov M.V., Kukharchuk V.V., Sergienko I.V. et al. Disorders of lipid metabolism. Clinical Guidelines 2023. Russian Journal of Cardiology. 2023;28(5):250-297. (In Russ.)] https://doi.org/10.15829/1560-4071-2023-5471.
2. Waldeyer C., Makarova N., Zeller T., et al. Lipoprotein(a) and the risk of cardiovascular disease in the European population: results from the BiomarCaRE consortium. Eur Heart J. 2017;38(32):24902498. https://doi.org/10.1093/eurheartj/ehx166.
3. Coassin S., Kronenberg F. Lipoprotein(a) beyond the kringle IV repeat polymorphism: the complexity of genetic variation in the LPA gene. Atherosclerosis. 2022;349:17-35.https://doi.org/10.1016/j.atherosclerosis.2022.04.003.
4. Lampsas S., Xenou M., Oikonomou E., et al.Lipoprotein(a) in Atherosclerotic Diseases: From Pathophysiology to Diagnosis and Treatment. Molecules. 2023;28(3):969. https://doi.org/10.3390/molecules28030969.
5. Kronenberg F., Mora S., Stroes E.S.G., et al. Lipoprotein(a) in atherosclerotic cardiovascular disease and aortic stenosis: a European Atherosclerosis Society consensus statement. Eur Heart J. 2022;43(39):3925-3946. https://doi.org/10.1093/eurheartj/ehac361.
6. Naglic D.T., Manojlovic M., Pejakovic S., et al. Lipoprotein(a): Role in atherosclerosis and new treatment options. Biomol Biomed. 2023;23(4):575-583. https://doi.org/10.17305/bb.2023.8992.
7. Ruscica M., Sirtori C.R., Corsini A., et al. Lipoprotein(a): Knowns, unknowns and uncertainties. Pharmacol. Res. 2021;173:105812. https://doi.org/10.1016/j.phrs.2021.105812.
8. Reyes-Soffer G., Ginsberg H.N., Berglund L., et al. Lipoprotein(a): A Genetically Determined, Causal, and Prevalent Risk Factor for Atherosclerotic Cardiovascular Disease: A Scientific Statement From the American Heart Association. Arterioscler Thromb Vasc Biol. 2022;42(1):e48-e60. https://doi.org/10.1161/ATV.0000000000000147.
9. Vinci P., Di Girolamo F.G., Panizon E., et al. Lipoprotein(a) as a Risk Factor for Cardiovascular Diseases: Pathophysiology and Treatment Perspectives. Int. J. Environ. Res. Public Health. 2023;20(18):6721. https://doi.org/10.3390/ijerph20186721.
10. Jawi M.M., Frohlich J., Chan S.Y. Lipoprotein(a) the insurgent: a new insight into the structure, function, metabolism, pathogenicity, and medications affecting lipoprotein(a) molecule. J Lipids. 2020;2020:3491764. https://doi.org/10.1155/2020/3491764.
11. Ferretti G., Bacchetti T., Johnston T.P., et al. Lipoprotein(a): A missing culprit in the management of athero-thrombosis? J. Cell. Physiol. 2018;233(4):2966-2981. https://doi.org/10.1002/jcp.26050.
12. Mack S., Coassin S., Rueedi R., et al. A genome-wide association meta-analysis on lipoprotein (а) concentrations adjusted for apolipoprotein (а) isoforms. J Lipid Res. 2017;58(9):1834-1844. https://doi.org/10.1194/jlr.M076232.
13. Hoekstra M., Chen H.Y., Rong J., et al. Genome-Wide association study highlights APOH as a novel locus for lipoprotein(a) levels-brief report. Arterioscler Thromb Vasc Biol. 2021;41(1):458464. https://doi.org/10.1161/ATVBAHA.120.314965.
14. Ugovšek S., Šebeštjen M. Lipoprotein(a)-The Crossroads of Atherosclerosis, Atherothrombosis and Inflammation. Biomolecules. 2021;12(1):26. https://doi.org/10.3390/biom12010026.
15. Després A.A., Perrot N., Poulin A., et al. Lipoprotein(a), oxidized phospholipids, and aortic valve microcalcification assessed by 18F-sodium fluoride positron emission tomography and computed tomography. CJC Open. 2019;1(3):131-40. https://doi.org/10.1016/j.cjco.2019.03.004.
16. Boffa M.B., Koschinsky M.L. Oxidized phospholipids as a unifying theory for lipoprotein(a) and cardiovascular disease. Nat. Rev. Cardiol. 2019;16:305-318. https://doi.org/10.1038/s41569-018-0153-2.
17. Kotani K., Banach M. Lipoprotein(a) and inhibitors of proprotein convertase subtilisin/kexin type 9. J. Thorac. Dis. 2017;9(1):E78-E82. https://doi.org/10.21037/jtd.2017.01.40.
18. Nissen S.E., Wolski K., Cho L., et al. Lipoprotein(a) levels in a global population with established atherosclerotic cardiovascular disease. Open Heart. 2022;9(2):e002060. http://doi.org/10.1136/openhrt-2022-002060corr1.
19. Ma G.S., Chiou T.T., Wilkinson M.J. Is Lipoprotein(a) Clinically Actionable with Today’s Evidence? The Answer is Yes. Curr Cardiol Rep. 2023;25(10):1175-1187. https://doi.org/10.1007%2Fs11886-023-01937-z.
20. Zhang J., Jia L., Yang Y., et al. Lipoprotein (а) and myocardial infarction: impact on long-term mortality. Lipids Health Dis. 2023;22:70. https://doi.org/10.1186%2Fs12944-023-01841-z.
21. Amiri M., Raeisi-Dehkordi H., Verkaar A.J.C.F., et al. Circulating lipoprotein (а)and all-cause and cause-specific mortality: a systematic review and dose-response meta-analysis. Eur J. Epidemiol. 2023;38(5):485-499. https://doi.org/10.1007/s10654-022-00956-4.
22. Hoogeveen R.C., Ballantyne C.M. Residual cardiovascular risk at low LDL: Remnants, lipoprotein(a), and inflammation. Clin. Chem. 2021;67(1):143-153. https://doi.org/10.1093/clinchem/hvaa252.
23. Liu T., Yoon W.S., Lee S.R. Recent updates of lipoprotein(a) and cardiovascular disease. ChonnamMed J. 2021;57(1):36-43. https://doi.org/10.4068/cmj.2021.57.1.36.
24. Schwartz G.G., Steg P.G., Szarek M., et al. Alirocumab and cardiovascular outcomes after acute coronary syndrome. N. Engl. J. Med. 2018;379(22):2097-107. https://doi.org/10.1056/nejmoa1801174.
25. Sabatine M.S., Giugliano R.P., Keech A.C., et al. Evolocumab and clinical outcomes in patients with cardiovascular disease. N. Engl. J. Med. 2017;376(18):1713-22. https://doi.org/10.1056/nejmoa1615664.
26. Jang A.Y., Lim S., Jo S.H., et al. New Trends in Dyslipidemia Treatment. Circ. J. 2021;85(6);759-768. https://doi.org/10.1253/circj.CJ-20-1037.
27. Tsimikas S., Karwatowska-Prokopczuk E., Gouni-Berthold I., et al. Lipoprotein(a) Reduction in Persons with Cardiovascular Disease. N. Engl. J. Med. 2020;382(3):244-255. https://doi.org/10.1056/nejmoa1905239.
28. Yeang C., Karwatowska-Prokopczuk E., Su F., et al. Effect of Pelacarsen on Lipoprotein(a) Cholesterol and Corrected Low-Density Lipoprotein Cholesterol. J. Am. Coll. Cardiol. 2022;79(11):1035-1046. https://doi.org/10.1016/j.jacc.2021.12.032.
29. Berk K.A., Borgeraas H., Narverud I., et al. Differential effects of bariatric surgery and lifestyle interventions on plasma levels of Lp(a) and fatty acids. Lipids Health Dis. 2022;21:145. https://doi.org/10.1186/s12944-022-01756-1.
30. Schwartz G.G., Ballantyne C.M., Barter P.J., et al. Association of Lipoprotein(a) With Risk of Recurrent Ischemic Events Following Acute Coronary Syndrome. Analysis of the dal-Outcomes Randomized Clinical Trial. JAMA Cardiol. 2018;3(2):164-168. https://doi.org/10.1001/jamacardio.2017.3833.
Supplementary files
Review
For citations:
Korotkova E.V., Zavyalov A.V., Kovalenko A.Yu. The Impact of Lipoprotein (A) on Autoinflammation and its Significance in Cardiogeriatrics. Russian Journal of Geriatric Medicine. 2024;(4):335-341. (In Russ.) https://doi.org/10.37586/2686-8636-4-2024-335-341