Lipoprotein(a): ein vergessener Risikofaktor?

Abstract

Lipoprotein(a) is a complex of LDL (low density lipoproteins) and apolipoprotein (a). In several meta-analyses it has been shown that lipoprotein(a) is a strong and independent risk factor of coronary artery disease, the prognostic importance of which increases at elevated global risk or in pre-existing coronary heart disease. Furthermore elevated serum concentrations of lipoprotein(a) may predict stroke, retinal vascular occlusion and venous thromboembolism. Lipoprotein(a) should be mainly measured in patients with intermediate cardiovascular risk according to conventional risk factors (PROCAM, SCORE, Framingham). Lowering high lipoprotein(a) is not straight forward, probably the most effective drug is nicotinic acid. Therefore, in the case of elevated lipoprotein(a) the therapeutic focus should be a more intensive treatment of the classical, modifyable risk factors (e. g. LDL cholesterin, blood pressure).

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