Lipoprotein(a)

Inherited risk for the cardiovascular system

(Bild: Tröster)

Lipoprotein(a) is the strongest genetic risk factor for coronary heart disease. Drugs to combat high levels are already being tested. But patients still have to be patient.

Lipoproteins bind free cholesterol in the blood and make it transportable. The lipoproteins HDL and LDL are common and play a role in the development of cardiovascular diseases and strokes.

However, there is another transport protein that is also associated with an increased risk of heart attacks and strokes: lipoprotein(a) - Lp(a) for short. The level of Lp(a) in the blood is determined by heredity. Lp(a) is therefore considered to be the strongest genetic risk factor for coronary heart disease.

Some substances in the test phase
Although there is currently no approved drug treatment for lowering Lp(a) levels, some substances are in clinical development. For example, substances that work on the basis of "small interfering RNA" (siRNA).

The use of siRNAs can prevent the body from producing lipoprotein(a). Another therapeutic approach is so-called "antisense oligonucleotides" (ASO), which have a similar effect and can prevent the production of Lp(a).

Lack of information on safety and efficacy
Even though several potential active substances are now being tested in phase II and phase III trials, sufficient information on safety and efficacy is still required before the trials can be completed. In addition, it has not yet been proven whether the new active ingredients actually reduce the number of strokes and heart attacks.

So far, the treatment of high Lp(a) levels has been limited to reducing all other risk factors (blood lipids, obesity, high blood pressure) in order to reduce the vascular risk. A healthy diet, regular exercise and abstaining from nicotine are also essential for this.