15289-s-bos

7 101 | Latest developments in the treatment of lipoprotein (a) Introduction Lipoprotein (a) (Lp(a)) is an low density lipoprotein (LDL) like particle with an apolipoprotein (apo(a)) moiety attached to it (figure 1[1])[2]. Multiple isoforms of apo(a) exist because the length of this protein is genetically determined by variations in the number of Kringle IV type 2 repeats encoded by the LPA gene [3]. The size of the apo(a) is inversely related with plasma Lp(a) levels [3]. In addition elevated plasma Lp(a) levels are causally related to cardiovascular disease (CVD), and the development of aortic valve calcification and aortic valve stenosis [4-7]. However, it is not known if reducing Lp(a) levels will also reduce the risk of CVD, because the first specific Lp(a) lowering compound has only recently been developed and outcome data is not yet available. The aim of this review is to give an overview of the current knowledge of Lp(a) modifying agents and interventions. Figure 7.1 | Lipoprotein(a) particle. Adapted from J E Roeters van Lennep and M T Mulder[1].