Journal News

Lipoprotein(a): Silent killer or crystal ball?

Aswathy Rai
Dec. 27, 2022

Lipoproteins are made up of lipids and the proteins that transport lipids. Lipoproteins in the blood shuttle lipids such as cholesterol and triglycerides from the intestine to tissues throughout the body.

Lipoprotein (a), or Lp(a), consists of cholesterol and two proteins, Apo-B 100 and Apo(a). High levels of Lp(a) accelerate the buildup of cholesterol on artery walls, increasing a person’s risk for acute coronary syndrome, or ACS, a blanket term for several diseases associated with sudden reduced blood flow to the heart. In the U.S., ACS affects 15.5 million people and is a leading cause of death.

Elena Aikawa’s lab at Brigham and Women’s Hospital in Boston focuses on studying the drivers of ACS and finding diagnostic biomarkers to identify populations at risk for cardiovascular diseases. In a collaborative study with Pawel Szulc’s lab at the University of Lyon published in the Journal of Lipid Research, postdoc Francesca Bartoli–Leonard and a team of researchers assessed whether a relationship exists between high levels of Lp(a) and ACS in older men.

“With the American Heart Association estimating a person has a heart attack every 41 seconds, it’s imperative we as scientists investigate how to predict these events in patients before they happen,” Bartoli–Leonard said.

The Lp(a) levels in the blood are determined by variations in the LPAgene locus. Hence even individuals with healthy diet and exercise habits may be at high risk for ACS if they have genetic variants that produce high Lp(a) levels.

“Unfortunately, the guidelines from the American Heart Association only suggest clinicians measure lipoprotein(a) in individuals with hypercholesterolemia,” Bartoli–Leonard said, “meaning there are large parts of the American population who may be at risk for lipoprotein(a)-driven cardiovascular disease who are simply unaware.”

Doctors manage ACS with apheresis, a filtering process that removes Lp(a) particles from the blood. No drugs are approved for reducing Lp(a) levels; however, some therapies are currently in clinical trials.

“Clinical treatment for cardiovascular disease can be costly,” Bartoli–Leonard said. “We wanted to find a marker that could be assessed once, and for a relatively low cost, that may help stratify which patients will have a coronary event.”

To determine risk, the team tracked Lp(a) in 755 men over age 60 who live in the same community, following their coronary events and overall health for up to eight years. The researchers report that participants with blood Lp(a) levels higher than 50 milligrams per deciliter had an increased incidence of ACS.

For, this investigation, only Caucasian males living in France were recruited in the study population. “However, these results are consistent with reports that included more diverse ethnic backgrounds and those assigned female at birth," the authors wrote in the paper.

The study provides further evidence that Lp(a) levels predict the likelihood of a coronary event independent of common risk factors such as smoking, body mass index and cholesterol levels.

“We hope that our work, alongside with the other studies, which also look at Lp(a) in the general population, encourage the health care providers to assess Lp(a) routinely in the clinic,” Bartoli–Leonard said.

Enjoy reading ASBMB Today?

Become a member to receive the print edition four times a year and the digital edition monthly.

Learn more
Aswathy Rai

Aswathy N. Rai is an assistant teaching professor and undergraduate coordinator at Mississippi State University's department of biochemistry, molecular biology, entomology and plant pathology. She is an ASBMB Today volunteer contributor.

Get the latest from ASBMB Today

Enter your email address, and we’ll send you a weekly email with recent articles, interviews and more.

Latest in Science

Science highlights or most popular articles

Hope for a cure hangs on research
Essay

Hope for a cure hangs on research

July 17, 2025

Amid drastic proposed cuts to biomedical research, rare disease families like Hailey Adkisson’s fight for survival and hope. Without funding, science can’t “catch up” to help the patients who need it most.

Before we’ve lost what we can’t rebuild: Hope for prion disease
Feature

Before we’ve lost what we can’t rebuild: Hope for prion disease

July 15, 2025

Sonia Vallabh and Eric Minikel, a husband-and-wife team racing to cure prion disease, helped develop ION717, an antisense oligonucleotide treatment now in clinical trials. Their mission is personal — and just getting started.

Defeating deletions and duplications
News

Defeating deletions and duplications

July 11, 2025

Promising therapeutics for chromosome 15 rare neurodevelopmental disorders, including Angelman syndrome, Dup15q syndrome and Prader–Willi syndrome.

Using 'nature’s mistakes' as a window into Lafora disease
Feature

Using 'nature’s mistakes' as a window into Lafora disease

July 10, 2025

After years of heartbreak, Lafora disease families are fueling glycogen storage research breakthroughs, helping develop therapies that may treat not only Lafora but other related neurological disorders.

Cracking cancer’s code through functional connections
News

Cracking cancer’s code through functional connections

July 2, 2025

A machine learning–derived protein cofunction network is transforming how scientists understand and uncover relationships between proteins in cancer.

Gaze into the proteomics crystal ball
In-person Conference

Gaze into the proteomics crystal ball

July 1, 2025

The 15th International Symposium on Proteomics in the Life Sciences symposium will be held August 17–21 in Cambridge, Massachusetts.