Lipoproteina(a) e rischio cardiovascolare: una roadmap per la gestione del paziente. Documento congiunto della Società Italiana per lo studio dell'Aterosclerosi (SISA), della Società Italiana di Cardiologia (SIC), della Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO) e di SIBioC

Lipoprotein(a) [Lp(a)] is a lipoprotein, characterized by structural elements common to low-density lipoproteins (LDL), such as apolipoprotein B-100 (apoB), but different from them mainly in the presence of apolipoprotein(a) [apo(a)], covalently linked to apoB. In recent years, interest in Lp(a) has grown considerably owing to epidemiological, genetic, and biological evidence supporting its causal role in cardiovascular diseases. Its heterogeneous structural characteristics, metabolic peculiarities, and ability to transport biologically active and potentially pro-atherogenic, pro-inflammatory, and pro-thrombotic components make it a unique lipoprotein among those containing apoB. Lp(a) is now recognized as a key risk factor in assessing cardiovascular risk owing to its causal and independent role in developing atherosclerotic disease and aortic valve stenosis. The assessment of Lp(a), integrated with other cardiovascular risk determinants, is now considered essential for correct clinical management and recognition of new therapeutic targets. Consequently, the need to include Lp(a) in the assessment of global cardiovascular risk has emerged, especially in subjects with a personal history of early or recurrent events, familial hypercholesterolemia, family history of early events, and family history of high levels of Lp(a). This document, the result of collaboration between the main Italian scientific societies involved in the management of cardiovascular diseases and laboratory medicine (SISA, SIC, ANMCO, and SIBioC), explores the pathogenetic role of Lp(a) and the clinical relevance of its measurement.