مقالات پذیرفته شده در نهمین کنگره بین المللی زیست پزشکی
A Narrative Review: Lipoprotein(a) and Its Role in Atherosclerosis and Thrombosis
A Narrative Review: Lipoprotein(a) and Its Role in Atherosclerosis and Thrombosis
Taranom Nazmi,1,*
1. Guilan University of Medical Sciences
Introduction: Apolipoprotein A (ApoA) is a major protein component of high-density lipoproteins (HDL) and plays a crucial role in reverse cholesterol transport. Previous studies have suggested that ApoA levels are inversely associated with the development of atherosclerosis, a key contributor to cardiovascular disease. This study aims to investigate the relationship between plasma ApoA concentrations, the progression of atherosclerotic lesions, and the incidence of thrombosis.
Methods: This narrative review was developed following the guidelines of the Integrative Critical Review approach. Relevant studies were identified through a structured search of PubMed, Scopus, and Web of Science. The search strategy used combinations of the terms “lipoprotein(a), Lp(a), apolipoprotein(a), atherosclerosis, thrombosis” and covered the period from 1970 to 1991. Additional references were obtained by screening the bibliographies of key papers. Studies were included if they addressed the structural characteristics of lipoprotein(a), its clinical associations with cardiovascular diseases, or its potential pathogenic mechanisms. Case reports, editorials, and non peer reviewed sources were excluded. The selected articles were examined for methodological quality and relevance. The evidence was analyzed through critical synthesis, focusing on consistent themes rather than statistical pooling, in order to highlight structural findings, clinical significance, and mechanistic hypotheses concerning lipoprotein(a)
Results: Our findings indicate that lower plasma levels of ApoA are significantly correlated with increased severity of atherosclerotic plaque formation and a higher incidence of thrombotic events. Histological analysis revealed more extensive lipid deposits and thrombus formation in subjects with reduced ApoA. Additionally, ApoA appears to exert protective effects against vascular inflammation and platelet aggregation, which may underlie its role in preventing thrombosis
Conclusion: High Lp(a) levels represent a powerful, independent risk factor for premature cardiovascular disease. Evidence supports its dual role in both atherosclerosis and thrombosis, positioning Lp(a) as a critical biomarker for cardiovascular risk assessment. Inclusion of Lp(a) measurement in clinical and research settings may provide new opportunities for prevention and treatment strategies.