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This review examines the structure, pathophysiology, and epidemiology of Lp(a), with a focus on its\u00a0contribution to ASCVD and related conditions such as aortic valve stenosis and peripheral artery disease. The main research\u00a0question addresses how Lp(a) influences cardiovascular risk and how emerging therapies may modify this risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This review synthesizes published evidence describing the biological characteristics of Lp(a), its mechanistic roles in disease, and its\u00a0epidemiologic associations with cardiovascular outcomes. It also evaluates current and investigational therapeutic approaches by\u00a0examining clinical trial data for agents targeting Lp(a).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Lp(a) contributes to residual cardiovascular risk through proatherogenic, proinflammatory, and prothrombotic mechanisms. Current\u00a0evidence highlights its involvement in ASCVD, aortic valve stenosis, and peripheral artery disease. Clinical studies of antisense\u00a0oligonucleotides, small interfering RNAs, oral small molecules, and CRISPR-based gene editing, including pelacarsen, olpasiran,\u00a0zerlasiran, lepodisiran, muvalaplin, and obicetrapib, demonstrate promising efficacy and safety. These agents show potential to\u00a0significantly reduce Lp(a) levels and influence future cardiovascular prevention strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>As novel therapies advance and clinical guidelines evolve, Lp(a) is emerging as a central determinant in personalized cardiovascular\u00a0care. The increasing emphasis on Lp(a) testing underscores its importance in risk stratification and future therapeutic decisionmaking.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10557-025-07810-1","type":"journal-article","created":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T07:11:51Z","timestamp":1763622711000},"page":"1187-1202","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Lipoprotein(a) in Cardiovascular Diseases and Emerging Therapeutic Strategies"],"prefix":"10.1007","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9146-2662","authenticated-orcid":false,"given":"Rami A.","family":"Al-Horani","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra C.","family":"Selico-Dunn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily Lauren Schenk","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,20]]},"reference":[{"key":"7810_CR1","doi-asserted-by":"publisher","first-page":"2361","DOI":"10.1016\/j.jacc.2022.11.005","volume":"80","author":"M Vaduganathan","year":"2022","unstructured":"Vaduganathan M, Mensah GA, Turco JV, Fuster V, Roth GA. 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