[Lipoprotein (a) :NSFA consensus].

LIPOPROTEIN(a) : NSFA CONSENSUS Lipoprotein(a), first described in 1963, consists of a low-density lipoprotein (LDL) associated with apolipoprotein(a) [apo(a)] which has a structural similarity with plasminogen but does not have fi-brinolytic activity. This complex structure determines the prothrom¬botic and antifibrinolytic action of high concentrations of Lp(a) and promotes the progression of atherosclerosis. Lp(a) has a propensity to remain in the arterial intima and to deposit its load of choleste¬rol and oxidized phospholipids at the sites of plaque formation. Lp(a) is characterized by a dramatically wide range of plasma concentrations (from 0.01 to > 3g/L, or from 2.5nmol/L to > 750nmol/L) that are mainly influenced by genetic factors and not by age, gender or lifestyle. The increase in its circulating concen¬tration is related to the increase in atherothrombotic risk. In this context, Lp(a) assays, although currently insufficiently standardized, are of considerable interest not only for cardiovascular risk strati¬fication in high-risk subjects, but also for the clinical follow-up of patients treated with new lipid-lowering therapies likely to signifi¬cantly reduce its circulating concentration, PCSK9 inhibitors, an¬ti-apo(a) antisense oligonucleotide «ONAS» and, ultimately, to improve the management of subjects at high cardiovascular risk.