Clinical and pathophysiological role of lipoprotein (a) in the development of diseases associated with atherosclerosis

O.V. Tsygankova^1,2, K.I. Bondareva², L.D. Latyntseva², A.A. Starichkova³

¹Novosibirsk State Medical University, Novosibirsk

²Institute of Internal and Preventive Medicine, the branch of the Federal Research Center "Institute of Cytology and Genetics of the Siberian Department of the Russian Academy of Sciences", Novosibirsk

³Federal Research Center of Fundamental and Translational Medicine, Novosibirsk

The article analyzes the literature data and clinical recommendations reflecting the role of lipoprotein (a) (Lp(a)) as a pro-atherogenic factor. The article shows the prevalence of a marked increase in this indicator. It also highlights the level of cardiovascular risk in such patients, which is comparable to that in hereditary heterozygous familial hypercholesterolemia. A review of available and developed medicines affecting Lp(a) was conducted. Along with this, we present our own clinical case of a female patient with a Lp(a) level of 440.25 nmol/l (with reference values up to 50 nmol/l) who experienced a transient ischemic attack at the age of 45 years in the setting of previously underdiagnosed arterial hypertension. Subsequently, the patient had preventable arterial hypertension, took combined antihypertensive therapy and rosuvastatin 10–20  mg/day on a regular basis with the target values achievement of low-density lipoprotein cholesterol. Despite this, at the age of 54, she experienced the onset of angina pectoris, and at the age of 56, magnetic resonance imaging of the brain in connection with cervicalgia revealed signs of an ischemic stroke of unknown duration in the right hemisphere. It shows the adverse contribution of Lp(a) high level to the pathogenesis of diseases associated with atherosclerosis.

Keywords: lipoprotein (a), dyslipidemia, diseases associated with atherosclerosis, high cardiovascular risk.

For citation: Tsygankova O.V., Bondareva K.I., Latyntseva L.D., Starichkova A.A. Clinical and pathophysiological role of lipoprotein (a) in the development of diseases associated with atherosclerosis. RMJ. 2020;12:4–8.