Lipoprotein(a) as a cardiovascular risk factor: current status
Open accessAbstract
AIMS: The aims of the study were, first, to critically evaluate lipoprotein(a) [Lp(a)] as a cardiovascular risk factor and, second, to advise on screening for elevated plasma Lp(a), on desirable levels, and on therapeutic strategies. METHODS AND RESULTS: The robust and specific association between elevated Lp(a) levels and increased cardiovascular disease (CVD)/coronary heart disease (CHD) risk, together with recent genetic findings, indicates that elevated Lp(a), like elevated LDL-cholesterol, is causally related to premature CVD/CHD. The association is continuous without a threshold or dependence on LDL- or non-HDL-cholesterol levels. Mechanistically, elevated Lp(a) levels may either induce a prothrombotic/anti-fibrinolytic effect as apolipoprotein(a) resembles both plasminogen and plasmin but has no fibrinolytic activity, or may accelerate atherosclerosis because, like LDL, the Lp(a) particle is cholesterol-rich, or both. We advise that Lp(a) be measured once, using an isoform-insensitive assay, in subjects at intermediate or high CVD/CHD risk with premature CVD, familial hypercholesterolaemia, a family history of premature CVD and/or elevated Lp(a), recurrent CVD despite statin treatment, ≥3% 10-year risk of fatal CVD according to European guidelines, and/or ≥10% 10-year risk of fatal + non-fatal CHD according to US guidelines. As a secondary priority after LDL-cholesterol reduction, we recommend a desirable level for Lp(a) <80th percentile (less than ∼50 mg/dL). Treatment should primarily be niacin 1-3 g/day, as a meta-analysis of randomized, controlled intervention trials demonstrates reduced CVD by niacin treatment. In extreme cases, LDL-apheresis is efficacious in removing Lp(a). CONCLUSION: We recommend screening for elevated Lp(a) in those at intermediate or high CVD/CHD risk, a desirable level <50 mg/dL as a function of global cardiovascular risk, and use of niacin for Lp(a) and CVD/CHD risk reduction.
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The risk increase associated with elevated Lp(a) was of lower magnitude than the one observed with LDL-C.
“However, the risk increase was of lower magnitude than the one observed with LDL-C [186, 191, 192].”
From Established and Emerging Lipid-Lowering Drugs for Primary and Secondary Cardiovascular Prevention (2023) · cites this paper as [192]
The Epidemiology section reports that elevated Lp(a) is associated with increased cardiovascular risk, including a relative risk of 1.13 for coronary heart disease per 3.5-fold higher Lp(a) level after adjustment. It does not establish that this risk increase is smaller than the increase associated with LDL-C; its discussion of LDL cholesterol concerns whether the Lp(a) association depends on LDL levels. (LLM, conf=0.85)
Experimental — accuracy not yet measuredPro-atherogenic effects of Lp(a) are attributed to pro-coagulant effects due to its similarity to plasminogen and to pro-inflammatory effects related to its oxidized phospholipid load.
“Pro-atherogenic effects of Lp(a) have also been attributed to pro-coagulant effects as Lp(a) has a similar structure to plasminogen, and it has pro-inflammatory effects most likely related to the oxidized phospholipid load carried by Lp(a) [71].”
From 2019 ESC/EAS guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk (2019) · cites this paper as [71]
No randomized intervention has shown that reducing lipoprotein(a) decreases cardiovascular disease risk.
“High concentrations of Lp(a) are associated with increased risk of CHD and ischaemic stroke, although there is no randomized intervention showing that reducing Lp(a) decreases CVD risk.480”
From European Guidelines on cardiovascular disease prevention in clinical practice (version 2012) (2012) · cites this paper as [480]
High concentrations of lipoprotein(a) are associated with increased risk of coronary heart disease and ischaemic stroke.
“High concentrations of Lp(a) are associated with increased risk of CHD and ischaemic stroke, although there is no randomized intervention showing that reducing Lp(a) decreases CVD risk.480”
From European Guidelines on cardiovascular disease prevention in clinical practice (version 2012) (2012) · cites this paper as [480]
Risk is regarded as significant when lipoprotein(a) is above the 80th percentile (50 mg/dL).
“The risk is regarded as significant when Lp(a) is above the 80th percentile (50 mg/dL). 109”
From 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias (2016) · cites this paper as [109]
The risk is regarded as significant when Lp(a) is above the 80th percentile (50 mg/dL).
“The risk is regarded as significant when Lp(a) is above the 80th percentile (50 mg/dL).109”
From 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias (2016) · cites this paper as [109]
Saturated fat lowers lipoprotein(a), an independent and causal cardiovascular risk factor, in comparison to monounsaturated fat or carbohydrate.
“Saturated fat also lower lipoprotein(a), an independent and casual cardiovascular risk factor,342 in comparison to monounsaturated fat or carbohydrate.343”
From Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity: A Comprehensive Review (2016) · cites this paper as [342]
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Cites
The Metabolic and Molecular Bases of Inherited Disease
Scriver, R. C. (1995) · Medical Entomology and Zoology · Cited by 12,101 · see citing works
Grundy, S. M., Cleeman, J. I., Merz, C. N. B., Brewer, H. B., Clark, L. T., Hunninghake, D. B., Pasternak, R. C., Smith, S. C., & Stone, N. J. (2004) · Circulation · doi:10.1161/01.cir.0000133317.49796.0e · Cited by 6,902 · see citing works
European guidelines on cardiovascular disease prevention in clinical practice: executive summary
Graham, I., Atar, D., Borch‐Johnsen, K., Boysen, G., Burell, G. K., Cífková, R., Dallongeville, J., Backer, G. D., Ebrahim, S. B. J., Gjelsvik, B., et al. (2007) · European Heart Journal · doi:10.1093/eurheartj/ehm316 · Cited by 3,840 · see citing works
Brown, G., Albers, J. J., Fisher, L. D., Schaefer, S. M., Lin, J.-T., Kaplan, C., Zhao, X.-Q., Bisson, B. D., Fitzpatrick, V. F., & Dodge, H. T. (1990) · New England Journal of Medicine · doi:10.1056/nejm199011083231901 · Cited by 2,159 · see citing works
Fifteen year mortality in Coronary Drug Project patients: long-term benefit with niacin
Canner, P. L., Berge, K. G., Wenger, N. K., Stamler, J., Friedman, L., Prineas, R. J., & Friedewald, W. (1986) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(86)80293-5 · Cited by 1,824 · see citing works
(2009) · JAMA · doi:10.1001/jama.2009.1063 · Cited by 1,753 · see citing works
Genetic Variants Associated with Lp(a) Lipoprotein Level and Coronary Disease
Clarke, R., Peden, J. F., Hopewell, J. C., Kyriakou, T., Goel, A., Heath, S. C., Parish, S., Barlera, S., Franzosi, M. G., Rust, S., et al. (2009) · New England Journal of Medicine · doi:10.1056/nejmoa0902604 · Cited by 1,671 · see citing works
Genetically Elevated Lipoprotein(a) and Increased Risk of Myocardial Infarction
Kamstrup, P. R. (2009) · JAMA · doi:10.1001/jama.2009.801 · Cited by 1,357 · cited 13× · see citing works
“The significant similar trend tests in three separate studies all point to increased CVD risk when the number of kringles is low and thus plasma levels of Lp(a) elevated.(2)”
BackgroundMethodInfluentialMendelian randomization: prospects, potentials, and limitations
Smith, G. D. (2004) · International Journal of Epidemiology · doi:10.1093/ije/dyh132 · Cited by 1,222 · see citing works
Lipoprotein(a) and Coronary Heart Disease
Danesh, J., Collins, R., & Peto, R. (2000) · Circulation · doi:10.1161/01.cir.102.10.1082 · Cited by 938 · see citing works
Oxidized Phospholipids, Lp(a) Lipoprotein, and Coronary Artery Disease
Tsimikas, S., Brilakis, E. S., Miller, E. R., McConnell, J. P., Lennon, R. J., Kornman, K. S., Witztum, J. L., & Berger, P. B. (2005) · New England Journal of Medicine · doi:10.1056/nejmoa043175 · Cited by 782 · see citing works
European guidelines on cardiovascular disease prevention in clinical practice: Executive summary
Graham, I. M. (2007) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2007.08.024 · Cited by 715 · see citing works
Carlson, L. A., & Rosenhamer, G. (1988) · Acta Medica Scandinavica · doi:10.1111/j.0954-6820.1988.tb15891.x · Cited by 685 · see citing works
Extended-Release Niacin or Ezetimibe and Carotid Intima–Media Thickness
Taylor, A. J., Villines, T. C., Stanek, E. J., Devine, P. J., Griffen, L., Miller, M. J., Weissman, N. J., & Turco, M. A. (2009) · New England Journal of Medicine · doi:10.1056/nejmoa0907569 · Cited by 643 · see citing works
Extreme Lipoprotein(a) Levels and Risk of Myocardial Infarction in the General Population
Kamstrup, P. R., Benn, M., Tybjærg‐Hansen, A., & Nordestgaard, B. G. (2007) · Circulation · doi:10.1161/circulationaha.107.715698 · Cited by 559 · see citing works
Self-citationBeneficial effects of colestipol-niacin on coronary atherosclerosis. A 4-year follow-up
Cashin-Hemphill, L. (1990) · JAMA · doi:10.1001/jama.264.23.3013 · Cited by 493 · see citing works
Use of the Thyroid Hormone Analogue Eprotirome in Statin-Treated Dyslipidemia
Ladenson, P. W., Kristensen, J. D., Ridgway, E. C., OLSSON, A. G., Carlsson, B., Klein, I. L., Baxter, J. D., & Angelin, B. (2010) · New England Journal of Medicine · doi:10.1056/nejmoa0905633 · Cited by 337 · see citing works
Apolipoprotein(a) Isoforms and the Risk of Vascular Disease
Erqou, S. A., Thompson, A., Angelantonio, E. D., Saleheen, D., Kaptoge, S., Marcovina, S. M., & Danesh, J. (2010) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2009.10.080 · Cited by 330 · see citing works
Effects of Lowering Elevated LDL Cholesterol on the Cardiovascular Risk of Lipoprotein(a)
Maher, V. M. G. (1995) · JAMA · doi:10.1001/jama.1995.03530220037029 · Cited by 297 · see citing works
Role of Lipoprotein(a) and Apolipoprotein(a) Phenotype in Atherogenesis
Kronenberg, F., Kronenberg, M. F., Kiechl, S. J., Trenkwalder, E., Santer, P., Oberhollenzer, F., Egger, G., Utermann, G., & Willeit, J. (1999) · Circulation · doi:10.1161/01.cir.100.11.1154 · Cited by 292 · see citing works
Marcovina, S. M., Koschinsky, M. L., Albers, J. J., & Skarlatos, S. (2003) · Clinical Chemistry · doi:10.1373/clinchem.2003.023689 · Cited by 288 · see citing works
Bennet, A. (2008) · Archives of Internal Medicine · doi:10.1001/archinte.168.6.598 · Cited by 281 · see citing works
Bruckert, E., Labreuche, J., & Amarenco, P. (2010) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2009.12.023 · Cited by 273 · see citing works
Self-citationRecommendations for the use of LDL apheresis
Thompson, G. R. (2008) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2008.02.009 · Cited by 270 · see citing works
Rader, D. J., Cain, W. J., Ikewaki, K., Talley, G. D., Zech, L. A., Usher, D. C., & Brewer, H. B. (1994) · Journal of Clinical Investigation · doi:10.1172/jci117292 · Cited by 235 · see citing works
Lipoprotein (a) as a predictor of coronary heart disease: the PRIME Study
Luc, G., Bard, J., Arveiler, D., Ferrières, J., Evans, A., Amouyel, P., Fruchart, J., & Ducimetière, P. (2002) · Atherosclerosis · doi:10.1016/s0021-9150(02)00026-6 · Cited by 227 · see citing works
Niacin and fibrates in atherogenic dyslipidemia: pharmacotherapy to reduce cardiovascular risk
Chapman, M. J., Redfern, J. S., McGovern, M. E., & Giral, P. (2010) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2010.01.008 · Cited by 227 · cited 1× · see citing works
“Studies using niacin alone or in combination with, for example, statins have shown cardiovascular benefit; 43 niacin reduces Lp(a) levels by up to 30–40% in a dose-dependent manner and in addition exerts other potential beneficial effects by reducing LDL cholesterol, total cholesterol, triglycerides, and remnant chole…”
BackgroundSelf-citationDanik, J. S., Rifai, N., Buring, J. E., & Ridker, P. M. (2006) · JAMA · doi:10.1001/jama.296.11.1363 · Cited by 215 · see citing works
Grundy, S. M., Cleeman, J. I., Merz, C. N. B., Brewer, H. B., Clark, L. T., Hunninghake, D. B., Pasternak, R. C., Smith, S. C., & Stone, N. J. (2004) · Arteriosclerosis Thrombosis and Vascular Biology · doi:10.1161/01.atv.0000133317.49796.0e · Cited by 195 · see citing works
Tybjærg‐Hansen, A., Steffensen, R., Meinertz, H., Schnohr, P., & Nordestgaard, B. G. (1998) · New England Journal of Medicine · doi:10.1056/nejm199805283382203 · Cited by 191 · see citing works
Self-citationvon Eckardstein, A., Schulte, H., Cullen, P., & Assmann, G. (2001) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(00)01126-8 · Cited by 186 · see citing works
Luke, M. M., Kane, J. P., Liu, D. M., Rowland, C. M., Shiffman, D., Cassano, J., Catanese, J. J., Pullinger, C. R., Leong, D. U., Arellano, A. R., et al. (2007) · Arteriosclerosis Thrombosis and Vascular Biology · doi:10.1161/atvbaha.107.141291 · Cited by 159 · see citing works
Sotiriou, S. N., Orlova, V. V., Al‐Fakhri, N., Ihanus, E., Economopoulou, M., Isermann, B., Bdeir, K. H., Nawroth, P. P., Preissner, K. T., Gahmberg, C. G., et al. (2006) · The FASEB Journal · doi:10.1096/fj.05-4857fje · Cited by 158 · see citing works
Merki, E., Graham, M. J., Mullick, A. E., Miller, E. R., Crooke, R. M., Pitas, R. E., Witztum, J. L., & Tsimikas, S. (2008) · Circulation · doi:10.1161/circulationaha.108.786822 · Cited by 156 · see citing works
Cantin, B., Gagnon, F., Moorjani, S., Després, J., Lamarche, B., Lupien, P. J., & Dagenais, G. R. (1998) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(97)00528-7 · Cited by 155 · see citing works
Tsimikas, S., Tsironis, L. D., & Tselepis, A. D. (2007) · Arteriosclerosis Thrombosis and Vascular Biology · doi:10.1161/01.atv.0000280571.28102.d4 · Cited by 152 · see citing works
Koschinsky, M. L., & Marcovina, S. M. (2004) · Current Opinion in Lipidology · doi:10.1097/00041433-200404000-00009 · Cited by 150 · see citing works
Matthews, K. A., Sowers, M. F., Derby, C. A., Stein, E. A., Miracle-McMahill, H. L., Crawford, S. L., & Pasternak, R. C. (2005) · American Heart Journal · doi:10.1016/j.ahj.2004.08.027 · Cited by 139 · see citing works
Rouy, D., Grailhe, P., Nigon, F., Chapman, J., & Anglés‐Cano, E. (1991) · Arteriosclerosis and Thrombosis A Journal of Vascular Biology · doi:10.1161/01.atv.11.3.629 · Cited by 133 · see citing works
Nielsen, L. B. (1999) · Atherosclerosis · doi:10.1016/s0021-9150(99)00064-7 · Cited by 115 · see citing works
Lipoprotein(a), Hormone Replacement Therapy, and Risk of Future Cardiovascular Events
Danik, J. S., Rifai, N., Buring, J. E., & Ridker, P. M. (2008) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2008.04.009 · Cited by 109 · see citing works
Does apolipoprotein(a) heterogeneity influence lipoprotein(a) effects on fibrinolysis?
Hervio, L., Chapman, M. J., Thillet, J., et al. (1993) · Blood · doi:10.1182/blood.v82.2.392.392 · Cited by 98 · see citing works
Self-citationModification of apolipoprotein(a) lysine binding site reduces atherosclerosis in transgenic mice.
Boonmark, N. W., Lou, X. J., Yang, Z. J., Schwartz, K., Zhang, J. L., Rubin, E. M., & Lawn, R. M. (1997) · Journal of Clinical Investigation · doi:10.1172/jci119565 · Cited by 90 · see citing works
Holmes, D. T., Schick, B. A., Humphries, K. H., & Frohlich, J. J. (2005) · Clinical Chemistry · doi:10.1373/clinchem.2005.055228 · Cited by 73 · see citing works
Gonbert, S., Malinsky, S., Sposito, A. C., Laouenan, H., Doucet, C., Chapman, M. J., & Thillet, J. (2002) · Atherosclerosis · doi:10.1016/s0021-9150(02)00072-2 · Cited by 70 · see citing works
Self-citationDefensin promotes the binding of lipoprotein(a) to vascular matrix.
Bdeir, K. H., Cane, W., Canziani, G., CHAIKEN, I. M., Weisel, J. W., Koschinsky, M. L., Lawn, R. M., Bannerman, P. G. C., Sachais, B. S., Kuo, A., et al. (1999) · PubMed · doi:10.1182/blood.v94.6.2007.418k12_2007_2019 · Cited by 68 · see citing works
Feric, N. T., Boffa, M. B., Johnston, S. M., et al. (2008) · Journal of Thrombosis and Haemostasis · doi:10.1111/j.1538-7836.2008.03183.x · Cited by 62 · see citing works
Clinical Lipidology: A Companion to Braunwald's Heart Disease
Ballantyne, C. M. (2014) · Cited by 61 · see citing works
Lipoprotein a: where are we now?
Τζιόμαλος, Κ., Athyros, V. G., Wierzbicki, A. S., & Mikhailidis, D. P. (2009) · Current Opinion in Cardiology · doi:10.1097/hco.0b013e32832ac21a · Cited by 56 · see citing works
Lundstam, U., Hurt‐Camejo, E., Olsson, G., Sartipy, P., Camejo, G., & Wiklund, O. (1999) · Arteriosclerosis Thrombosis and Vascular Biology · doi:10.1161/01.atv.19.5.1162 · Cited by 51 · see citing works
Nordestgaard, B. G. (2009) · Current Opinion in Lipidology · doi:10.1097/mol.0b013e3283307bfe · Cited by 48 · see citing works
Self-citationPan, S., Kleppe, L. S., Witt, T. A., et al. (2004) · Thrombosis and Haemostasis · doi:10.1160/th04-01-0006 · Cited by 43 · see citing works
Koschinsky, M. L., & Marcovina, S. M. (2009) · Elsevier eBooks · doi:10.1016/b978-141605469-6.50015-9 · Cited by 11 · see citing works
Bateman, T. M., Case, J. A., Cullom, S. J., Bamhart, C., & O’Keefe, J. H. (1998) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(98)80614-1 · Cited by 8 · see citing works
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Research works printed but not linked: 1
- [13]13. Goldstein JL, Hobbs HH, Brown MS. Familial hypercholesterolemia. In: Scriver CR, Beaudet AL, Sly WS, Valle D, eds. The Metabolic and Molecular Bases of Inherited Disease. 8th ed. New York: McGraw-Hill; 2001. p2863 -2913.
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Authors/Task Force Members:, Perk, J., De Backer, G., Gohlke, H., Graham, I., Reiner, Ž., Verschuren, M., Albus, C., Benlian, P., Boysen, G., et al. (2012) · European Heart Journal · doi:10.1093/eurheartj/ehs092 · Cited by 8,490 · see citing works
Self-citation2016 European Guidelines on cardiovascular disease prevention in clinical practice
Piepoli, M. F., Hoes, A. W., Agewall, S., Albus, C., Brotons, C., Catapano, A. L., Cooney, M.-T., Corrà, U., Cosyns, B., Deaton, C., et al. (2016) · European Heart Journal · doi:10.1093/eurheartj/ehw106 · Cited by 6,457 · see citing works
Self-citationMach, F., Baigent, C., Catapano, A. L., Koskinas, K. C., Casula, M., Badimon, L., Chapman, M. J., De Backer, G. G., Delgado, V., Ference, B. A., et al. (2019) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2019.08.014 · Cited by 4,854 · see citing works
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Reiner, Ž., Catapano, A. L., De Backer, G., Graham, I., Taskinen, M.-R., Wiklund, O., Agewall, S., Alegria, E., Chapman, M. J., Durrington, P., et al. (2011) · European Heart Journal · doi:10.1093/eurheartj/ehr158 · Cited by 3,549 · see citing works
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Catapano, A. L., Graham, I., De Backer, G., Wiklund, O., Chapman, M. J., Drexel, H., Hoes, A. W., Jennings, C. S., Landmesser, U., Pedersen, T. R., et al. (2016) · European Heart Journal · doi:10.1093/eurheartj/ehw272 · Cited by 3,162 · see citing works
Self-citationNordestgaard, B. G., Chapman, M. J., Humphries, S. E., Ginsberg, H. N., Masana, L., Descamps, O. S., Wiklund, O., Hegele, R. A., Raal, F. J., Defesche, J. C., et al. (2013) · European Heart Journal · doi:10.1093/eurheartj/eht273 · Cited by 2,761 · see citing works
Self-citationMeschia, J. F., Bushnell, C., Boden-Albala, B., Braun, L. T., Bravata, D. M., Chaturvedi, S., Creager, M. A., Eckel, R. H., Elkind, M. S. V., Fornage, M., et al. (2014) · Stroke · doi:10.1161/str.0000000000000046 · Cited by 2,650 · see citing works
Mozaffarian, D. (2016) · Circulation · doi:10.1161/circulationaha.115.018585 · Cited by 2,216 · see citing works
Borén, J., Chapman, M. J., Krauss, R. M., Packard, C. J., Bentzon, J. F., Binder, C. J., Daemen, M. J., Demer, L. L., Hegele, R. A., Nicholls, S. J., et al. (2020) · European Heart Journal · doi:10.1093/eurheartj/ehz962 · Cited by 1,601 · see citing works
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Self-citationChapman, M. J., Ginsberg, H. N., Amarenco, P., Andreotti, F., Borén, J., Catapano, A. L., Descamps, O. S., Fisher, E., Kovanen, P. T., Kuivenhoven, J. A., et al. (2011) · European Heart Journal · doi:10.1093/eurheartj/ehr112 · Cited by 1,227 · see citing works
Self-citationAnderson, T. J., Grégoire, J., Pearson, G. J., Barry, A. R., Couture, P., Dawes, M., Francis, G. A., Genest, J., Grover, S., Gupta, M., et al. (2016) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2016.07.510 · Cited by 1,173 · see citing works
A Test in Context: Lipoprotein(a)
Tsimikas, S. (2017) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2016.11.042 · Cited by 1,137 · see citing works
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Thanassoulis, G., Campbell, C. Y., Owens, D. S., Smith, J. G., Smith, A. V., Peloso, G. M., Kerr, K. F., Pechlivanis, S., Budoff, M. J., Harris, T. B., et al. (2013) · New England Journal of Medicine · doi:10.1056/nejmoa1109034 · Cited by 1,008 · see citing works
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O’Donoghue, M. L., Fazio, S., Giugliano, R. P., Stroes, E. S. G., Kanevsky, E., Gouni-Berthold, I., Im, K., Lira Pineda, A., Wasserman, S. M., Češka, R., et al. (2019) · Circulation · doi:10.1161/circulationaha.118.037184 · Cited by 984 · see citing works
Ginsberg, H. N., Packard, C. J., Chapman, M. J., Borén, J., Aguilar-Salinas, C. A., Averna, M., Ference, B. A., Gaudet, D., Hegele, R. A., Kersten, S., et al. (2021) · European Heart Journal · doi:10.1093/eurheartj/ehab551 · Cited by 979 · see citing works
Self-citationWiegman, A., Gidding, S. S., Watts, G. F., Chapman, M. J., Ginsberg, H. N., Cuchel, M., Ose, L., Averna, M., Boileau, C., Borén, J., et al. (2015) · European Heart Journal · doi:10.1093/eurheartj/ehv157 · Cited by 891 · see citing works
Self-citationNordestgaard, B. G., Langsted, A., Mora, S., Kolovou, G., Baum, H., Bruckert, E., Watts, G. F., Sypniewska, G., Wiklund, O., Borén, J., et al. (2016) · European Heart Journal · doi:10.1093/eurheartj/ehw152 · Cited by 847 · see citing works
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Raal, F. J., Kallend, D., Ray, K. K., Turner, T., Koenig, W., Wright, R. S., Wijngaard, P. L. J., Curcio, D., Jaros, M. J., Leiter, L. A., et al. (2020) · New England Journal of Medicine · doi:10.1056/nejmoa1913805 · Cited by 818 · see citing works
Self-citationESC/EAS Guidelines for the management of dyslipidaemias
Catapano, A. L., Reiner, Ž., De Backer, G., Graham, I., Taskinen, M.-R., Wiklund, O., Agewall, S., Alegria, E., Chapman, M. J., Durrington, P., et al. (2011) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2011.06.028 · Cited by 706 · see citing works
Self-citationBurgess, S., Ference, B. A., Staley, J. R., Freitag, D. F., Mason, A. M., Nielsen, S. F., Willeit, P., Young, R., Surendran, P., Karthikeyan, S., et al. (2018) · JAMA Cardiology · doi:10.1001/jamacardio.2018.1470 · Cited by 689 · see citing works
Self-citationFamilial Hypercholesterolemia: Screening, diagnosis and management of pediatric and adult patients
Goldberg, A. C., Hopkins, P. N., Toth, P. P., Ballantyne, C. M., Rader, D. J., Robinson, J. G., Daniels, S. R., Gidding, S. S., de Ferranti, S. D., Ito, M. K., et al. (2011) · Journal of clinical lipidology · doi:10.1016/j.jacl.2011.03.001 · Cited by 622 · see citing works
Elevated Lipoprotein(a) and Risk of Aortic Valve Stenosis in the General Population
Kamstrup, P. R., Tybjærg-Hansen, A., & Nordestgaard, B. G. (2014) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2013.09.038 · Cited by 595 · see citing works
Self-citationNordestgaard, B. G., & Langsted, A. (2016) · Journal of Lipid Research · doi:10.1194/jlr.r071233 · Cited by 575 · see citing works
Self-citationWilleit, P., Ridker, P. M., Nestel, P. J., Simes, J., Tonkin, A. M., Pedersen, T. R., Schwartz, G. G., Olsson, A. G., Colhoun, H. M., Kronenberg, F., et al. (2018) · The Lancet · doi:10.1016/s0140-6736(18)31652-0 · Cited by 564 · see citing works
Lipoprotein(a): resurrected by genetics
Kronenberg, F., & Utermann, G. (2013) · Journal of Internal Medicine · doi:10.1111/j.1365-2796.2012.02592.x · Cited by 521 · see citing works
Khera, A. V., Everett, B. M., Caulfield, M. P., Hantash, F. M., Wohlgemuth, J., Ridker, P. M., & Mora, S. (2014) · Circulation · doi:10.1161/circulationaha.113.004406 · Cited by 461 · see citing works
Lipoprotein (a) measurements for clinical application
Marcovina, S. M., & Albers, J. J. (2016) · Journal of Lipid Research · doi:10.1194/jlr.r061648 · Cited by 338 · see citing works
Koenig, W. (2013) · International Journal of Cardiology · doi:10.1016/j.ijcard.2013.07.113 · Cited by 315 · see citing works
Arsenault, B. J., Boekholdt, S. M., Dubé, M.-P., Rhéaume, É., Wareham, N. J., Khaw, K.-T., Sandhu, M. S., & Tardif, J.-C. (2014) · Circulation: Cardiovascular Genetics · doi:10.1161/circgenetics.113.000400 · Cited by 315 · see citing works
High lipoprotein(a) and high risk of mortality
Langsted, A., Kamstrup, P. R., & Nordestgaard, B. G. (2019) · European Heart Journal · doi:10.1093/eurheartj/ehy902 · Cited by 288 · see citing works
Self-citationExtreme lipoprotein(a) levels and improved cardiovascular risk prediction
Kamstrup, P. R., Tybjærg-Hansen, A., & Nordestgaard, B. G. (2013) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2012.12.023 · Cited by 284 · see citing works
Self-citationDiscrimination and Net Reclassification of Cardiovascular Risk With Lipoprotein(a)
Willeit, P., Kiechl, S., Kronenberg, F., Witztum, J. L., Santer, P., Mayr, M., Xu, Q., Mayr, A., Willeit, J., & Tsimikas, S. (2014) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2014.03.061 · Cited by 286 · see citing works
Davidson, M. H., Ballantyne, C. M., Jacobson, T. A., Bittner, V. A., Braun, L. T., Brown, A. S., Brown, W. V., Cromwell, W. C., Goldberg, R. B., McKenney, J. M., et al. (2011) · Journal of Clinical Lipidology · doi:10.1016/j.jacl.2011.07.005 · Cited by 262 · see citing works
Langlois, M. R., Chapman, M. J., Cobbaert, C., Mora, S., Remaley, A. T., Ros, E., Watts, G. F., Borén, J., Baum, H., Bruckert, E., et al. (2018) · Clinical Chemistry · doi:10.1373/clinchem.2018.287037 · Cited by 260 · see citing works
Self-citationVarbo, A., Benn, M., & Nordestgaard, B. G. (2014) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2013.11.008 · Cited by 251 · see citing works
Self-citationNordestgaard, B. G., Langlois, M. R., Langsted, A., Chapman, M. J., Aakre, K. M., Baum, H., Borén, J., Bruckert, E., Catapano, A., Cobbaert, C., et al. (2020) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2019.12.005 · Cited by 240 · see citing works
Self-citationPreclinical development and phase 1 trial of a novel siRNA targeting lipoprotein(a)
Koren, M. J., Moriarty, P. M., Baum, S. J., Neutel, J., Hernandez-Illas, M., Weintraub, H. S., Florio, M., Kassahun, H., Melquist, S., Varrieur, T., et al. (2022) · Nature Medicine · doi:10.1038/s41591-021-01634-w · Cited by 239 · see citing works
Self-citationRoeseler, E., Julius, U., Heigl, F., Spitthoever, R., Heutling, D., Breitenberger, P., Leebmann, J., Lehmacher, W., Kamstrup, P. R., Nordestgaard, B. G., et al. (2016) · Arteriosclerosis, Thrombosis, and Vascular Biology · doi:10.1161/atvbaha.116.307983 · Cited by 227 · see citing works
Self-citationA Test in Context: Lipid Profile, Fasting Versus Nonfasting
Nordestgaard, B. G. (2017) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2017.08.006 · Cited by 223 · see citing works
Self-citationFrom Lipids to Inflammation: New Approaches to Reducing Atherosclerotic Risk
Shapiro, M. D., & Fazio, S. (2016) · Circulation Research · doi:10.1161/circresaha.115.306471 · Cited by 217 · see citing works
Kamstrup, P. R., & Nordestgaard, B. G. (2016) · JACC: Heart Failure · doi:10.1016/j.jchf.2015.08.006 · Cited by 206 · see citing works
Self-citationNonfasting versus fasting lipid profile for cardiovascular risk prediction
Langsted, A., & Nordestgaard, B. G. (2019) · Pathology · doi:10.1016/j.pathol.2018.09.062 · Cited by 191 · see citing works
Self-citationESC/EAS Guidelines for the management of dyslipidaemias
Catapano, A. L., Reiner, Ž., De Backer, G., Graham, I., Taskinen, M.-R., Wiklund, O., Agewall, S., Alegria, E., Chapman, M. J., Durrington, P., et al. (2011) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2011.06.012 · Cited by 192 · see citing works
Self-citationBalling, M., Afzal, S., Varbo, A., Langsted, A., Davey Smith, G., & Nordestgaard, B. G. (2020) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2020.09.610 · Cited by 175 · see citing works
Self-citationF. Piepoli, M. (2017) · International Journal of Behavioral Medicine · doi:10.1007/s12529-016-9583-6 · Cited by 162 · see citing works
Langsted, A., Nordestgaard, B. G., Benn, M., Tybjærg-Hansen, A., & Kamstrup, P. R. (2016) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2016-1206 · Cited by 136 · see citing works
Self-citationNational lipid association annual summary of clinical lipidology 2016
Bays, H. E., Jones, P. H., Orringer, C. E., Brown, W. V., & Jacobson, T. A. (2016) · Journal of Clinical Lipidology · doi:10.1016/j.jacl.2015.08.002 · Cited by 128 · see citing works
Fogacci, F., Ferri, N., Toth, P. P., Ruscica, M., Corsini, A., & Cicero, A. F. G. (2019) · Drugs · doi:10.1007/s40265-019-01114-z · Cited by 132 · see citing works
C-Reactive Protein: Clinical and Epidemiological Perspectives
Salazar, J., Martínez, M. S., Chávez, M., Toledo, A., Añez, R., Torres, Y., Apruzzese, V., Silva, C., Rojas, J., & Bermúdez, V. (2014) · Cardiology Research and Practice · doi:10.1155/2014/605810 · Cited by 117 · see citing works
Tsimikas, S., Fazio, S., Viney, N. J., Xia, S., Witztum, J. L., & Marcovina, S. M. (2018) · Journal of Clinical Lipidology · doi:10.1016/j.jacl.2018.07.003 · Cited by 109 · see citing works
Established and Emerging Lipid-Lowering Drugs for Primary and Secondary Cardiovascular Prevention
Michaeli, D. T., Michaeli, J. C., Albers, S., Boch, T., & Michaeli, T. (2023) · American Journal of Cardiovascular Drugs · doi:10.1007/s40256-023-00594-5 · Cited by 109 · see citing works
“However, the risk increase was of lower magnitude than the one observed with LDL-C [186, 191, 192].”
BackgroundLipoprotein(a): fasting and nonfasting levels, inflammation, and cardiovascular risk
Langsted, A., Kamstrup, P. R., & Nordestgaard, B. G. (2014) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2014.01.049 · Cited by 103 · see citing works
Self-citationNew therapeutic principles in dyslipidaemia: focus on LDL and Lp(a) lowering drugs
Norata, G. D., Ballantyne, C. M., & Catapano, A. L. (2013) · European Heart Journal · doi:10.1093/eurheartj/eht088 · Cited by 99 · see citing works
Self-citationImpact of Apolipoprotein(a) Isoform Size on Lipoprotein(a) Lowering in the HPS2-THRIVE Study
Parish, S., Hopewell, J. C., Hill, M. R., Marcovina, S., Valdes-Marquez, E., Haynes, R., Offer, A., Pedersen, T. R., Baigent, C., Collins, R., et al. (2018) · Circulation: Genomic and Precision Medicine · doi:10.1161/circgen.117.001696 · Cited by 93 · see citing works
Shapiro, M. D., Minnier, J., Tavori, H., Kassahun, H., Flower, A., Somaratne, R., & Fazio, S. (2019) · Journal of the American Heart Association · doi:10.1161/jaha.118.010932 · Cited by 70 · see citing works
Ray, K. K., Vallejo-Vaz, A. J., Ginsberg, H. N., Davidson, M. H., Louie, M. J., Bujas-Bobanovic, M., Minini, P., Eckel, R. H., & Cannon, C. P. (2019) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2019.06.896 · Cited by 69 · see citing works
Self-citationCardiovascular Disease in Women
Stock, E. O., & Redberg, R. (2012) · Current Problems in Cardiology · doi:10.1016/j.cpcardiol.2012.07.001 · Cited by 65 · see citing works
Dyslipidemia management for primary prevention of cardiovascular events: Best in-clinic practices
Thongtang, N., Sukmawan, R., Llanes, E. J. B., & Lee, Z.-V. (2022) · Preventive Medicine Reports · doi:10.1016/j.pmedr.2022.101819 · Cited by 61 · see citing works
Update on the laboratory investigation of dyslipidemias
Ramasamy, I. (2018) · Clinica Chimica Acta · doi:10.1016/j.cca.2018.01.015 · Cited by 50 · see citing works
Li, N., Li, Q., Tian, X.-Q., Qian, H.-Y., & Yang, Y.-J. (2014) · American Journal of Cardiovascular Drugs · doi:10.1007/s40256-014-0077-0 · Cited by 45 · see citing works
Healthy Dietary Interventions and Lipoprotein (a) Plasma Levels: Results from the Omni Heart Trial
Haring, B., Wyler von Ballmoos, M. C., Appel, L. J., & Sacks, F. M. (2014) · PLoS ONE · doi:10.1371/journal.pone.0114859 · Cited by 46 · see citing works
Monitoring of lipids, enzymes, and creatine kinase in patients on lipid-lowering drug therapy
Wiklund, O., Pirazzi, C., & Romeo, S. (2013) · Current Cardiology Reports · doi:10.1007/s11886-013-0397-8 · Cited by 45 · see citing works
Apolipoprotein profiling as a personalized approach to the diagnosis and treatment of dyslipidaemia
Renee Ruhaak, L., van der Laarse, A., & Cobbaert, C. M. (2019) · Annals of Clinical Biochemistry: International Journal of Laboratory Medicine · doi:10.1177/0004563219827620 · Cited by 38 · see citing works
Lipoprotein apheresis is an optimal therapeutic option to reduce increased Lp(a) levels
Scientific Board of GLAR for the German Apheresis Working Group, Schettler, V. J. J., Neumann, C. L., Peter, C., Zimmermann, T., Julius, U., Hohenstein, B., Roeseler, E., Heigl, F., Grützmacher, P., et al. (2019) · Clinical Research in Cardiology Supplements · doi:10.1007/s11789-019-00094-4 · Cited by 37 · see citing works
Clouet-Foraison, N., Gaie-Levrel, F., Gillery, P., & Delatour, V. (2017) · Clinical Chemistry and Laboratory Medicine (CCLM) · doi:10.1515/cclm-2017-0091 · Cited by 30 · see citing works
Karwatowska-Prokopczuk, E., Clouet-Foraison, N., Xia, S., Viney, N. J., Witztum, J. L., Marcovina, S. M., & Tsimikas, S. (2021) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2021.03.036 · Cited by 27 · see citing works
Langlois, M. R., & Nordestgaard, B. G. (2018) · Current Cardiology Reports · doi:10.1007/s11886-018-1036-1 · Cited by 19 · see citing works
Self-citationFerence, B. A. (2019) · Clinical Pharmacology & Therapeutics · doi:10.1002/cpt.1163 · Cited by 8 · see citing works
Hu, J., Wang, J., Zhang, H., Jiang, Y., Deng, L., Long, E., & Liu, S. (2026) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2026.1758366 · Cited by 3 · see citing works
Wu, A.-X., Wang, X.-J., Zhao, C., Hu, J.-Q., Li, J.-W., Xu, Y., Li, Y., & Liu, S. (2026) · Pharmacological Research · doi:10.1016/j.phrs.2026.108178 · Cited by 1 · see citing works
Skrabic, R., Kumric, M., Santic, R., Skrabic, I., Pavlovic, N., Rusic, D., & Bozic, J. (2026) · Frontiers in Nutrition · doi:10.3389/fnut.2026.1875074
- Authors
- Nordestgaard, B. G., Chapman, M. J., Ray, K., Borén, J., Andreotti, F., Watts, G. F., Ginsberg, H., Amarenco, P., Catapano, A., Descamps, O. S., Fisher, E., Kovanen, P. T., Kuivenhoven, J. A., Lesnik, P., Masana, L., Reiner, Z., Taskinen, M.-R., Tokgözoglu, L., & Tybjærg-Hansen, A.
- Affiliations
- University of Copenhagen (DK)
- Inserm (FR)
- St George's, University of London (GB)
- University of Gothenburg (SE)
- Università Cattolica del Sacro Cuore (IT)
- The University of Western Australia (AU)
- Columbia University (US)
- Hôpital Bichat-Claude-Bernard (FR)
- University of Milan (IT)
- Hôpital de Jolimont (BE)
- New York University (US)
- Wihuri Research Institute (FI)
- University of Amsterdam (NL)
- Universitat Rovira i Virgili (ES)
- Corresponding author
- Nordestgaard, Børge G.
- ORCID
- Venue
- European Heart Journal
- Publisher
- Oxford University Press (OUP)
- Published
- 2010-10-21
- Volume
- 31
- Issue
- 23
- Pages
- 2844-2853
- ISSN
- 0195-668X (ISSN-L)
- 1522-9645
- PMC
- PMC3295201
- OpenAlex
- W2098890974
- Semantic Scholar
- 696debc961236c391ab92d3525f7b8b370ae6e5f
- Cited by
- 1,807
- References
- 54
- Citations by year
- 2026: 98 · 2025: 89 · 2024: 127 · 2023: 103 · 2022: 145 · 2021: 125 · 2020: 129 · 2019: 140 · 2018: 118 · 2017: 131 · 2016: 145 · 2015: 115 · 2014: 101 · 2013: 103 · 2012: 78
- FWCI
- 79.66
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- other-oa
- Locations
- European Heart Journal (publishedVersion, other-oa)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion)
- HAL (submittedVersion, other-oa)
- UWA Profiles and Research Repository (UWA) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Hacettepe University Institutional Repository (hacettepe.edu.tr) (submittedVersion, other-oa)
- Pure Amsterdam UMC (submittedVersion)
- Spiral (Imperial College London) (submittedVersion, other-oa)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Funders
- AstraZeneca
- Kowa Company
- European Atherosclerosis Society
- National Heart, Lung, and Blood Institute (R01HL073030)
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Surgery › Cholesterol and Lipid Metabolism
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipid metabolism and disorders
- Keywords
- lipoprotein(a), cardiovascular risk, coronary artery disease, Lp(a) screening, niacin therapy, LDL apheresis, apolipoprotein(a), atherosclerosis, familial hypercholesterolemia, cardiovascular risk stratification
- MeSH terms
- Age Factors, Animals, Cardiovascular Diseases, Coronary Disease, Female, Humans, Hyperlipoproteinemias, Immunoassay, Male, Mice, Transgenic, Risk Factors, Sex Factors, Lipoprotein(a), Patient Selection, Early Diagnosis, Mice
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