Abstract
Numerous randomized controlled trials have investigated the efficacy of optimal medical therapy (OMT) for atherosclerotic cardiovascular disease (ASCVD), specifically chronic coronary syndrome. Mounting evidence has shown that low-density lipoprotein (LDL)-lowering therapy is the cornerstone of OMT and improves the prognosis. Lipoprotein A [Lp(a)], identified in 1963, is an important risk factor for ASCVD independent of other traditional risk factors, including LDL cholesterol. Lp(a) is an apolipoprotein B (apoB)-containing lipoprotein that contains LDL-like particles. Lp(a) has been suggested to be a causal factor for ASCVD, but no substantial evidence supports this because there is currently no medical therapy that specifically reduces Lp(a). However, several novel drugs, including oligonucleotide therapeutics, are currently undergoing clinical trials that may yield the required evidence. This review describes the current understanding and future perspectives of Lp(a), which is currently considered a mere biomarker but can be a novel therapeutic target in the near future.
