Cited by 309Blood Coagulation and Thrombosis MechanismsLipoproteins and Cardiovascular HealthLipid metabolism and disorders

Lipoprotein (a): truly a direct prothrombotic factor in cardiovascular disease?

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Boffa, Michael B., Koschinsky, Marlys L.·2016·Journal of Lipid Research

Abstract

Elevated plasma concentrations of lipoprotein (a) [Lp(a)] have been determined to be a causal risk factor for coronary heart disease, and may similarly play a role in other atherothrombotic disorders. Lp(a) consists of a lipoprotein moiety indistinguishable from LDL, as well as the plasminogen-related glycoprotein, apo(a). Therefore, the pathogenic role for Lp(a) has traditionally been considered to reflect a dual function of its similarity to LDL, causing atherosclerosis, and its similarity to plasminogen, causing thrombosis through inhibition of fibrinolysis. This postulate remains highly speculative, however, because it has been difficult to separate the prothrombotic/antifibrinolytic functions of Lp(a) from its proatherosclerotic functions. This review surveys the current landscape surrounding these issues: the biochemical basis for procoagulant and antifibrinolytic effects of Lp(a) is summarized and the evidence addressing the role of Lp(a) in both arterial and venous thrombosis is discussed. While elevated Lp(a) appears to be primarily predisposing to thrombotic events in the arterial tree, the fact that most of these are precipitated by underlying atherosclerosis continues to confound our understanding of the true pathogenic roles of Lp(a) and, therefore, the most appropriate therapeutic target through which to mitigate the harmful effects of this lipoprotein.

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Authors
Boffa, M. B., & Koschinsky, M. L.
Affiliations
  • University of Windsor (CA)
  • Western University (CA)
Corresponding author
Koschinsky, Marlys L.
Venue
Journal of Lipid Research
Publisher
Elsevier BV
Published
2016-05
Volume
57
Issue
5
Pages
745-757
ISSN
0022-2275 (ISSN-L)
OpenAlex
W2234206893
Cited by
309
References
145
Citations by year
2026: 37 · 2025: 44 · 2024: 37 · 2023: 32 · 2022: 30 · 2021: 29 · 2020: 33 · 2019: 33 · 2018: 20 · 2017: 8 · 2016: 6
FWCI
1.70
Type
journal article
Language
en
Open access
Locations
  • Journal of Lipid Research (publishedVersion, cc-by)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • Canadian Institutes of Health Research (126076)
  • Heart and Stroke Foundation of Canada (G-13-0003091)
  • Natural Sciences and Engineering Research Council of Canada (RGPIN/05006-2015)
Topics
  • Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
  • Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipid metabolism and disorders
Keywords
lipoprotein(a), coronary artery disease, atherosclerosis, arterial thrombosis, venous thrombosis, fibrinolysis inhibition, plasminogen, apolipoprotein(a), cardiovascular risk factors, therapeutic target
MeSH terms
Animals, Cardiovascular Diseases, Humans, Hyperlipidemias, Plasminogen, Thrombosis, Lipoprotein(a), Structural Homology, Protein

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