Lipoprotein(a)

Lipoprotein (a) belongs to the plasma lipoproteins and has a largely similar structure to low density lipoprotein (LDL). Lipoprotein(a) has two apolipoproteins:

• Apolipoprotein B-100, which also occurs as a protein component in LDL and VLDL
• and
• Apolipoprotein(a).

Apolipoprotein (a) is very similar to plasminogen. It is assumed that this structural similarity leads to interactions of lipoprotein(a) with fibrinolysis.

Lipoprotein(a) is synthesized in the liver. It has a half-life in the circulation of 3-4 days. The individual plasma value is genetically determined. Concentrations of Lp(a) < 20 mg/dl are considered normal, > 30 mg/dl as safely elevated.

Lp(a) concentrations >30mg/dl are considered an independent atherosclerotic risk factor. Lp(a) increases the expression of plasminogen activator inhibitor-1, which probably inhibits local fibrinolysis.

The therapeutic influence of increased Lp(a) levels is limited. Only nicotinic acid, mainly in combination with statins, can lead to a clinically relevant reduction.

In this respect, it is of particular importance for affected patients to consistently treat cardiovascular risk factors.