This animation explains how elevated Lp(a) levels increase cardiovascular risk in people with FH.
Lp(a) is an atherogenic, ApoB-containing lipoprotein that consists of an LDL particle in which the ApoB molecule is attached to a separate variably sized apolipoprotein called apo(a). Apo(a) has a structural similarity with plasminogen, the precursor of plasmin, and may inhibit the conversion of plasminogen to plasmin. Plasmin degrades fibrin blood clots. With less plasmin to break down fibrin, fibrin concentration increases, promoting thrombogenesis. Apo(a) may also bind to plasminogen sites and fibrin, increasing the atherogenic and thrombogenic potential of Lp(a) compared to LDL.
Lp(a) combines the atherogenicity of LDL and the thrombogenicity of apo(a). In addition, Lp(a) carries and deposits oxidized phospholipids, increasing inflammation. Elevated Lp(a) levels increase cardiovascular risk in the general patient population as well as in patients with familial hypercholesterolemia.