Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Jul;44(7):1485-1490.
doi: 10.1161/ATVBAHA.124.319483. Epub 2024 Jun 26.

Lipoprotein(a) in the Year 2024: A Look Back and a Look Ahead

Sotirios Tsimikas  1
Affiliations
Review

Lipoprotein(a) in the Year 2024: A Look Back and a Look Ahead

Sotirios Tsimikas. Arterioscler Thromb Vasc Biol. 2024 Jul.

Abstract

In fitting with the American Heart Association’s 100th anniversary of its founding and Arteriosclerosis, Thrombosis and Vascular Biology organizing a Centennial Collection to celebrate this event, lipoprotein(a) [Lp(a)] celebrates its 61st birthday in November 2024. There has been substantial progress in understanding the biology and pathophysiology of Lp(a) in the last 6 decades, including its discovery as a unique β-lipoprotein containing the pathognomonic apolipoprotein(a) moiety covalently bound to apolipoprotein B-100, its independent monogenetic association with cardiovascular disease and calcific aortic valve disease, its increased content of pro-atherogenic and pro-inflammatory of oxidized phospholipids relative to other lipoproteins and the development of RNA therapeutics to lower plasma Lp(a) levels. The validation or refutation of the “Lp(a) hypothesis”, namely that lowering plasma Lp(a) will lead to clinical benefit, is ongoing in 3 clinical outcomes trials. This essay reviews the discovery of Lp(a), summarizes the seminal pathophysiological findings since its discovery, discusses ongoing clinical trials with novel drugs and approaches, and provides a look ahead to unanswered questions.

Keywords: biology; cholesterol; lipoprotein(a); lipoproteins, LDL; therapeutics.

PubMed Disclaimer

Conflict of interest statement

Disclosures S. Tsimikas is a coinventor and receives royalties from patents owned by the University of California San Diego (UCSD) and is a cofounder and has an equity interest in Oxitope and Kleanthi Diagnostics and has a dual appointment at UCSD and Ionis Pharmaceuticals. The terms of this arrangement have been reviewed and approved by the UCSD in accordance with its conflicts-of-interest policies.

Figures

Figure.
Figure.
Kåre Berg at approximately 60 years of age. The first page of original article describing the discovery of Lp(a) along with relevant text enunciating the hypothesis behind the study.
See this image and copyright information in PMC

References

    1. Berg K A New Serum Type System in Man--the Lp System. Acta pathologica et microbiologica Scandinavica. 1963;59:369–82. - PubMed
    1. Lipoprotein(a). Contemporary Cardiology, Kostner K, Kostner GM, Toth PP (Eds), Humana press, pp. 1–443. 2023
    1. Berg K, Dahlen G, Frick MH. Lp(a) lipoprotein and pre-beta1-lipoprotein in patients with coronary heart disease. Clin Genet. 1974;6:230–5. - PubMed
    1. Albers JJ, Hazzard WR. Immunochemical quantification of human plasma Lp(a) lipoprotein. Lipids. 1974;9:15–26. - PubMed
    1. Kostner GM, Avogaro P, Cazzolato G, Marth E, Bittolo-Bon G, Qunici GB. Lipoprotein Lp(a) and the risk for myocardial infarction. Atherosclerosis. 1981;38:51–61. - PubMed

Publication types