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Lp(a) contributes to endothelial dysfunction, promotes vascular inflammation and enhances lipid retention and oxidation within the arterial wall. These changes drive foam cell formation and smooth muscle cell activation, hallmarks of early plaque development. In addition, Lp(a) exerts prothrombotic effects through structural homology with plasminogen, interfering with fibrinolysis and promoting thrombosis, which may increase the risk of plaque rupture and acute events. Collectively, these overlapping mechanisms underscore the unique contribution of Lp(a) to both the development and progression of atherosclerosis. As novel targeting therapies emerge, a deeper understanding of Lp(a) biology will be essential for translating these insights into clinical benefit.<\/jats:p>","DOI":"10.15420\/ecr.2025.66","type":"journal-article","created":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T19:13:09Z","timestamp":1771441989000},"source":"Crossref","is-referenced-by-count":6,"title":["Presumed Mechanisms Underlying Lipoprotein(a)-caused Atherosclerosis"],"prefix":"10.15420","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-9292-9965","authenticated-orcid":false,"given":"Annalisa","family":"Filtz","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/044ntvm43","id-type":"ROR","asserted-by":"publisher"}],"name":"Montefiore Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leandro","family":"Slipczuk","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/044ntvm43","id-type":"ROR","asserted-by":"publisher"}],"name":"Montefiore Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0735-9756","authenticated-orcid":false,"given":"Martha","family":"Gulati","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/027zt9171","id-type":"ROR","asserted-by":"publisher"}],"name":"Houston Methodist"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"6096","published-online":{"date-parts":[[2026,2,23]]},"reference":[{"key":"ref0","unstructured":"World Health Organization. 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