The significance of lipoprotein (a) in assessment of risk for atherosclerosis
Kullich, W.; Machreich, K.
Wiener Medizinische Wochenschrift 144(17): 407-411
1994
ISSN/ISBN: 0043-5341 PMID: 7839688 Document Number: 433377
Lipoprotein(a) [Lp(a)] consists like the low-density-lipoprotein (LDL) in the structure protein apolipoprotein B, but is additionally connected with apolipoprotein(a), which is highly homologous to plasminogen. The physiological function of Lp(a) is yet not entirely clear. Lp(a) is established to be an independent factor in the genesis of atherosclerosis however. With occurrence of high Lp(a) Lp(a) plasma levels and other atherogenous risk factors at the same time a potentiation of their effects on genesis of atherosclerosis is observed. Unfortunately the therapeutic possibilities of counteracting the high atherogenicity of Lp(a) are still limited, because LDL apheresis as the only known effective technique today cannot be applied in all cases. In several studies it has been shown, that Lp(a) concentrations can be reduced mainly by long term treatment with lipid-lowering sustained-release bezafibrate, ACE-inhibitor fosinopril, alpha-tocopheryl-nicotinate and N-acetylcysteine. Because of the synergistic effects of atherogenous risk factors patients with high Lp(a) concentrations should avoid additional risk factors such as hypertension, smoking, diet increasing LDL, etc.