Lipoproteína(a): Biomarcador y factor de riesgo en aterosclerosis – de la fisiopatología a la práctica clínica
DOI:
https://doi.org/10.33448/rsd-v14i3.48379Palabras clave:
Lipoproteína(a), Aterosclerosis, Enfermedades cardiovasculares.Resumen
Introducción: La Lp(a) es una lipoproteína estructuralmente similar a la LDL, compuesta principalmente por ApoB-100 y apolipoproteína(a). Es ampliamente reconocida como un factor de riesgo para enfermedades cardiovasculares debido a su influencia en procesos ateroscleróticos, inflamatorios y trombogénicos. Objetivo: El objetivo de esta investigación es realizar una revisión bibliográfica sobre la lipoproteína(a), los mecanismos fisiopatológicos involucrados en el desarrollo de lesiones ateroscleróticas, su uso clínico actual y una visión general de las opciones terapéuticas. Método: Se realizó una revisión narrativa de la literatura utilizando las bases de datos: PubMed, Cochrane, JAMA y Scielo. Se emplearon los siguientes descriptores: “Lipoproteína(a)”, “Aterosclerosis” y “Enfermedades cardiovasculares”. Se seleccionaron 78 estudios publicados en los últimos 40 años en inglés que demostraron relevancia para el tema. Resultados y discusión: La Lp(a) se acumula en las lesiones ateroscleróticas, se une a la matriz extracelular y transporta fosfolípidos oxidados, promoviendo inflamación, disfunción endotelial e inestabilidad de las placas. Además, interfiere en la fibrinólisis y aumenta la agregación plaquetaria, favoreciendo la trombosis. Los estudios evidencian que niveles elevados de Lp(a) están asociados con un mayor riesgo de enfermedad aterosclerótica, consolidándola como un biomarcador independiente de eventos cardiovasculares. Las guías clínicas recomiendan la medición de Lp(a) al menos una vez en la vida. Conclusión: La lipoproteína(a) [Lp(a)] es reconocida como un biomarcador independiente y un factor de riesgo cardiovascular significativo, implicado en la fisiopatología de la aterosclerosis, la trombogenicidad y la inflamación vascular. Las terapias dirigidas han surgido como alternativas prometedoras; sin embargo, aún existen lagunas sobre si la reducción terapéutica de Lp(a) impacta clínicamente en la prevención de eventos cardiovasculares.
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