Cardiovascular Implications of Lipoprotein(a) and its Genetic Variants

Dyslipidemia, a significant risk factor for cardiovascular diseases (CVDs), is prevalent in the Middle East (ME) countries. With a variable prevalence, elevated lipoprotein (a) [Lp(a)] is the most widespread monogenic dyslipidemic disorder. Genetic studies have established Lp(a) as a heritable and independent risk factor for CVD. This discovery has shifted the perception of Lp(a) and the LPA gene from mere biomarkers of atherosclerotic risk to a viable target for therapeutic intervention. Significant differences in serum Lp(a) levels have been observed across racial and ethnic groups, with few independent genetic variants affecting Lp(a) levels outside the LPA gene region. Data specific to the ME and Arab populations remains scarce. ME populations exhibit genetic diversity and higher consanguinity rates, which may uniquely influence Lp(a) distribution and associated variations. This review examines the genetic and observational factors that shape Lp(a) levels and their role in CVD risk, focusing on ME populations.