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Role of lipoprotein (a) in the development of ischemic stroke and other cardiovascular diseases

https://doi.org/10.14412/2074-2711-2016-1-90-95

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Abstract

The paper gives the data available in the literature on the role of a level of elevated lipoprotein (a) (Lp (a)) in the development of ischemic stroke and other cardiovascular diseases. It shows the normal level of Lp (a) and the typical distribution of its concentration for people of European origin and representatives of other races. There is evidence on the genetic determination and variability of the Apo (a) gene. The paper presents the results of the recent large survey of 8000 patients with coronary heart disease and 8000 control persons, which has studied candidate genes for cardiovascular diseases. It indicates the role of Lp (a) as a risk factor for early atherosclerosis and describes main pathomorphological mechanisms. The propositions that it is necessary to screen Lp (a) in different risk groups, its target level, and possible methods for correcting the elevated Lp (a) level are given.

About the Authors

N. A. Pizov
Yaroslavl State Medical University, Ministry of Health of Russia, Yaroslavl, Russia 5, Revolyutsionnaya St., Yaroslavl 150000
Russian Federation
Department of Neurology and Medical Genetics with Course of Neurosurgery


N. V. Pizova
Yaroslavl State Medical University, Ministry of Health of Russia, Yaroslavl, Russia 5, Revolyutsionnaya St., Yaroslavl 150000
Russian Federation
Department of Neurology and Medical Genetics with Course of Neurosurgery


References

1. Utermann G. Lipoprotein(a). In: Scriver CR, Beaudet AL, Sly WS, Valle D, editors. The Metabolic and Molecular Bases of Inherited Disease. 8th ed. New York: McGraw-Hill; 2001. P. 2753-87.

2. Kamstrup PR, Tybjaerg-Hansen A, Steffensen R, NordestgaardBG. Genetically elevated lipoprotein(a) and increased risk of myocardial infarction. JAMA. 2009 Jun 10;301(22):2331-9. doi: 10.1001/jama.2009.801.

3. Erqou S, Kaptoge S, Perry PL, et al. Lipoprotein(a) concentration and the risk of coronary heart disease, stroke, and nonvascular mortality. JAMA. 2009 Jul 22;302(4):412-23. doi: 10.1001/jama.2009.1063.

4. Clarke R, Peden JF, Hopewell JC, et al. Genetic variants associated with Lp(a) lipoprotein level and coronary disease. N Engl J Med. 2009 Dec 24;361(26):2518-28. doi: 10.1056/NEJMoa0902604.

5. Cantin B, Gagnon F, Moorjani S, et al. Is lipoprotein(a) an independent risk factor for ischemic heart disease in men? The Quebec Cardiovascular Study. J Am Coll Cardiol. 1998 Mar 1;31(3):519-25.

6. Luc G, Bard JM, Arveiler D, et al. Lipoprotein (a) as a predictor of coronary heart disease: the PRIME Study. Atherosclerosis. 2002 Aug;163(2):377-84.

7. Suk DJ, Rifai N, Buring JE, Ridker PM. Lipoprotein(a), measured with an assay independent of apolipoprotein(a) isoform size, and risk of future cardiovascular events among initially healthy women. JAMA. 2006 Sep 20; 296(11):1363-70.

8. Marcovina SM, Koschinsky ML. Lipoprotein(a) as a risk factor for coronary artery disease. Am J Cardiol. 1998 Dec 17;82(12A):57U-66U; discussion 86U.

9. Anuurad E, Boffa MB, Koschinsky ML, Berglund L. Lipoprotein(a): a unique risk factor for cardiovascular disease. Clin Lab Med. 2006;26(4):751-772.

10. Hobbs HH, White AL. Lipoprotein(a): intrigues and insights. Curr Opin Lipidol. 1999 Jun;10(3):225-36.

11. Nielsen LB, Gronholdt ML, Schroeder TV, et al. In vivo transfer of lipoprotein(a) into human atherosclerotic carotid arterial intima. Arterioscler Thromb Vasc Biol. 1997 May; 17(5):905-11.

12. Boffa MB, Marcovina SM, Koschinsky ML. Lipo-protein(a) as a risk factor for atherosclerosis and thrombosis: mechanistic insights from animal models. Clin Biochem. 2004 May; 37(5):333-43.

13. Poon M, Zhang X, Dunsky KG, et al. Apolipoprotein(a) induces monocyte chemotactic activity in human vascular endothelial cells. Circulation. 1997 Oct 21;96(8):2514-9.

14. Nielsen LB, Juul K, Nordestgaard BG. Increased degradation of lipoprotein(a) in atherosclerotic com-pared with nonlesioned aortic intima-inner media of rabbits: in vivo evidence that lipoprotein(a) may con-tribute to foam cell formation. Arterioscler Thromb Vasc Biol. 1998 Apr;18(4):641-9.

15. Nielsen LB. Atherogenecity of lipoprotein(a) and oxidized low density lipoprotein: insightfrom in vivo studies of arterial wall influx, degradation and efflux. Atherosclerosis. 1999 Apr;143(2):229-43.

16. Lundstam U, Hurt-Camejo E, Olsson G, et al. Proteoglycans contribution to association of Lp(a) and LDL with smooth muscle cell extracellular matrix. Arterioscler Thromb Vasc Biol. 1999 May;19(5):1162-7.

17. Bdeir K, Cane W, Canziani G, et al. Defensinpromotes the binding of lipoprotein(a) to vascular matrix. Blood. 1999 Sep 15; 94(6):2007-19.

18. Boonmark NW, Lou XJ, Yang ZJ, et al. Modification of apolipoprotein(a) lysine binding site reduces atherosclerosis in transgenic mice. J Clin Invest. 1997 Aug 1;100(3):558-64.

19. Tsimikas S, Brilakis ES, Miller ER, et al. Oxidized phospholipids, Lp(a) lipoprotein, and coronary artery disease. N Engl J Med. 2005 Jul 7;353(1):46-57.

20. Tsimikas S, Tsironis LD, Tselepis AD. New insights into the role of lipoprotein(a)- associatedlipoprotein-associatedphospholipase A2 in atherosclerosis and cardiovascular disease. Arterioscler Thromb Vasc Biol. 2007 Oct;27(10):2094-9. Epub 2007 Jul 12.

21. Rouy D, Grailhe P, Nigon F, et al. Lipoprotein(a) impairs generation of plasmin by fibrin-bound tissue-type plasminogen activator. In vitro studies in a plasma milieu. Arterioscler Thromb. 1991 May-Jun;11(3):629-38.

22. Feric NT, Boffa MB, Johnston SM, Koschinsky ML. Apolipoprotein(a) inhibits the conversion of Glu-plasminogen to Lysplasminogen: a novel mechanism for lipoprotein(a)-mediated inhibition of plasminogen activation. J Thromb Haemost. 2008 Dec;6(12):2113-20. doi: 10.1111/j.1538-7836.2008.03183.x. Epub 2008 Oct 4.

23. Pan S, Kleppe LS, Witt TA, et al. The effect of vascular smooth muscle cell-targeted expression of tissue factor pathway inhibitor in a murine model of arterial thrombosis. Thromb Haemost. 2004 Sep;92(3):495-502.

24. Hervio L, Chapman MJ, Thillet J, et al. Does apolipoprotein(a) heterogeneity influence lipoprotein(a) effects on fibrinolysis? Blood. 1993 Jul 15;82(2):392-7.

25. Erqou S, Thompson A, Di AE, et al. Apolipoprotein(a) isoforms and the risk of vascular disease: systematic review of 40 studies involving 58,000 participants. J Am Coll Cardiol. 2010 May 11;55(19):2160-7. doi: 10.1016/ j.jacc.2009.10.080.

26. Kronenberg F, KronenbergMF, Kiechl S, et al. Role of lipoprotein(a) and apolipoprotein( a) phenotype in atherogenesis: prospective results from the Bruneck study. Circulation. 1999 Sep 14;100(11):1154-60.

27. Matthews KA, Sowers MF, Derby CA, et al. Ethnic differences in cardiovascular risk factor burden among middle-aged women: Study of Women's Health Across the Nation (SWAN). Am Heart J. 2005 Jun;149(6):1066-73.

28. Rader DJ, Cain W, Ikewaki K, et al. The inverse association of plasma lipoprotein (a) concentrations with apolipoprotein (a) isoform size is not due to differences in Lp(a) catabolism but to differences in production rate. J Clin Invest. 1994 Jun;93(6): 2758-63.

29. Marcovina SM, Koschinsky ML, Albers JJ, Skarlatos S. Report of the National Heart, Lung, and Blood Institute Workshop on Lipoprotein(a) and Cardiovascular Disease: recent advances andfuture directions. Clin Chem. 2003 Nov;49(11):1785-96.

30. Koschinsky M, Marcovina SM. Lipoprotein(a). In: Ballantyne C, editor. Clinical Lipidology: A Companion to Braunwauld's Heart Disease. Philadelphia: Saunders Elsevier; 2009. P. 130-43.

31. Luke MM, Kane JP, Liu DM, et al. A polymorphism in the protease-like domain of apolipoprotein(a) is associated with severe coronary artery disease. Arterioscler Thromb Vasc Biol. 2007 Sep;27(9):2030-6. Epub 2007 Jun 14.

32. Holmes DT, Schick BA, Humphries KH, Frohlich J. Lipoprotein(a) is an independent risk factor for cardiovascular disease in heterozygous familial hypercholesterolemia. Clin Chem. 2005 Nov;51(11):2067-73. Epub 2005 Sep 1.

33. Armstrong VW, Cremer P, Eberle E, et al. The association between serum Lp(a) concentrations and angiographically assessed coronary atherosclerosis. Dependence on serum LDL levels. Atherosclerosis. 1986 Dec;62(3):249-57.

34. Hoefler G, Harnocout F, Paschke E, et al. Lipoprotein Lp(a). A risk factor for myocardial infarction. Arteriosclerosis. 1988 Jul-Aug;8(4):398-401.

35. Sandkamp M, Funke H, Schulte H, et al. Lipoprotein(a) is an independent risk factor for myocardial infarction at a young age. Clin Chem. 1990 Jan;36(1):20-3.

36. Hopkins PN, Wu LL, Hunt SC, et al. Lipoprotein(a) interactions with lipid and nonlipid risk factors in early familial coronary artery disease. Arterioscler Thromb Vasc Biol. 1997 Nov;17(11):2783-92.

37. von Eckardstein A, Schulte H, Cullen P, Assmann G. Lipoprotein(a) Further Increases the Risk of Coronary Events in Men With High Global Cardiovascular Risk. J Am Coll Cardiol. 2001 Feb;37(2):434-9.

38. Milionis HJ, Filippatos TD, Loukas T, et al. Serum lipoprotein(a) levels and apolipoprotein( a) isoform size and risk for first-ever acute ischaemic nonembolic stroke in elderly individuals. Atherosclerosis. 2006 Jul;187(1):170-6. Epub 2005 Sep 28.

39. Petersen NH, Schmied AB, Zeller JA, et al. Lp(a) Lipoprotein and Plasminogen Activity in Patients with Different Etiology of Ischemic Stroke. Cerebrovasc Dis. 2007;23(2-3):188-93. Epub 2006 Dec 1.

40. Rigal M, Ruidavets JB, Viguier A, et al. Lipoprotein (a) and risk of ischemic stroke in young adults. J Neurol Sci. 2007 Jan 15; 252(1):39-44. Epub 2006 Nov 20.

41. Emerging Risk Factors Collaboration, Erqou S, Kaptoge S, Perry PL, et al. Lipoprotein(a) concentration and the risk of coronary heart disease, stroke, and nonvascular mortality. JAMA. 2009 Jul 22;302(4):412-23. doi: 10.1001/jama.2009.1063.

42. Jü rgens G, Taddei-Peters WC, Kö ltringer P, et al Lipoprotein(a) serum concentration and apolipoprotein(a) phenotype correlate with severity and presence of ischemic cerebrovascular disease. Stroke. 1995 Oct;26(10):1841-8.

43. Sutton-Tyrrell K, Evans RW, Meilahn E, Alcorn HG. Lipoprotein(a) and peripheral atherosclerosis in older adults. Atherosclerosis. 1996 Apr 26;122(1):11-9.

44. Kivimä ki M, Magnussen CG, Juonala M, et al. Conventional and Mendelian randomization analyses suggest no association between lipoprotein(a) and early atherosclerosis: the Young Finns Study. Int J Epidemiol. 2011 Apr;40(2):470-8. doi: 10.1093/ije/dyq205. Epub 2010 Nov 14.

45. Grebe MT, Schoene E, Schaefer CA, et al. Elevated lipoprotein(a) does not promote early atherosclerotic changes of the carotid arteries in young, healthy adults. Atherosclerosis. 2007 Jan; 190(1):194-8. Epub 2006 Feb 21.

46. Nasr N, Ruidavets JB, Farghali A, et al. Lipoprotein (a) and Carotid Atherosclerosis in Young Patients With Stroke. Stroke. 2011 Dec; 42(12):3616-8. doi: 10.1161/STROKEAHA. 111.624684. Epub 2011 Sep 22.

47. Graham I, Atar D, Borch-Johnsen K, et al. European guidelines on cardiovascular disease prevention in clinical practice: executive summary: Fourth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (Constituted by representatives of nine societies and by invited experts). Eur Heart J. 2007 Oct;28(19):2375-414. Epub 2007 Aug 28.

48. Grundy SM, Cleeman JI, Merz CN, et al. Implications of recent clinical trialsfor the National Cholesterol Education Program Adult Treatment Panel III guidelines. Arterioscler Thromb Vasc Biol. 2004 Aug;24(8):e149-61.

49. Bruckert E, Labreuche J, Amarenco P. Meta-analysis of the effect of nicotinic acid alone or in combination on cardiovascular events and atherosclerosis. Atherosclerosis. 2010 Jun;210(2):353-61. doi: 10.1016/j.atherosclerosis. 2009.12.023. Epub 2009 Dec 21.

50. Carlson LA, Rosenhamer G. Reduction in mortality in the Stockholm Ischemic Heart Disease Secondary Prevention Study by combined treatment with clofibrate and nicotinic acid. Acta Med Scand. 1988;223(5):405-18.

51. Canner PL, Berge KG, Wenger NK, et al Fifteen year mortality in Coronary Drug Project patients: long-term benefit with niacin. J Am Coll Cardiol. 1986 Dec;8(6):1245-55.

52. Cashin-Hemphill L, Mack WJ, Pogoda JM, et al Beneficial effects of colestipol-niacin on coronary atherosclerosis. A 4-year follow-up. JAMA. 1990 Dec 19;264(23):3013-7.

53. Brown G, Albers JJ, Fisher LD, et al Regression of coronary artery disease as a result of ntensive lipid-lowering therapy in men with high levels of apolipoprotein B. N Engl J Med. 1990 Nov 8;323(19):1289-98.

54. Taylor AJ, Villines TC, Stanek EJ, et al Extended-release niacin or ezetimibe and carotid intima-media thickness. N Engl J Med. 2009 Nov 26;361(22):2113-22. doi: 10.1056/ NEJMoa0907569. Epub 2009 Nov 15.

55. Koschinsky M, Marcovina SM. Lipoprotein(a). In: Ballantyne C, editor. Clinical Lipidology: A Companion to Braunwauld's Heart Disease. Philadelphia: Saunders Elsevier; 2009. P. 130-43

56. Tziomalos K, Athyros VG, Wierzbicki AS, Mikhailidis DP. Lipoprotein a: where are we now? Curr Opin Cardiol. 2009 Jul;24(4):351-7. doi: 10.1097/HCO.0b013e32832ac21a.

57. Gonbert S, Malinsky S, Sposito AC, et al. Atorvastatin lowers lipoprotein(a) but not apolipoprotein(a) fragment levels in hypercholesterolemic subjects at high cardiovascular risk. Atherosclerosis. 2002 Oct;164(2):305-11.

58. Suk DJ, Rifai N, Buring JE, Ridker PM. Lipoprotein(a), hormone replacement therapy, and isk of future cardiovascular events. J Am Coll Cardiol. 2008 Jul 8;52(2):124-31. doi: 10.1016/j.jacc.2008.04.009.


For citation:


Pizov N.A., Pizova N.V. Role of lipoprotein (a) in the development of ischemic stroke and other cardiovascular diseases. Neurology, Neuropsychiatry, Psychosomatics. 2016;8(1):90-95. (In Russ.) https://doi.org/10.14412/2074-2711-2016-1-90-95

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