Lipoprotein(a) [Lp(a)] is a highly heritable cardiovascular risk factor. Although discovered more than 50 years ago, Lp(a) has recently re-emerged as a major focus in the fields of lipidology and preventive cardiology owing to findings from genetic studies and the possibility of lowering elevated plasma concentrations with new antisense therapy. Data from genetic, epidemiological and clinical studies have provided compelling evidence establishing Lp(a) as a causal risk factor for atherosclerotic cardiovascular disease. Nevertheless, major gaps in knowledge remain and the identification of the mechanistic processes governing both Lp(a) pathobiology and metabolism are an ongoing challenge. Furthermore, the complex structure of Lp(a) presents a major obstacle to the accurate quantification of plasma concentrations, and a universally accepted and standardized approach for measuring Lp(a) is required. Significant progress has been made in the development of novel therapeutics for selectively lowering Lp(a). However, before these therapies can be widely implemented further investigations are required to assess their efficacy, safety, and cost-efficiency in the prevention of cardiovascular events. We review recent advances in molecular and biochemical aspects, epidemiology, and pathobiology of Lp(a), and provide a contemporary update on the significance of Lp(a) in clinical medicine.

“Progress lies not in enhancing what is, but in advancing toward what will be.” (Khalil Gibran)

脂蛋白（a）[Lp（a）]是高度可遗传的心血管危险因素。尽管发现Lp（a）已有50多年的历史，但由于遗传学研究的结果以及采用新的反义疗法降低血浆浓度升高的可能性，Lp（a）最近重新成为脂质学和预防性心脏病学领域的主要关注点。来自遗传，流行病学和临床研究的数据提供了令人信服的证据，将Lp（a）确立为动脉粥样硬化性心血管疾病的致病危险因素。然而，知识上的主要空白仍然存在，并且确定控制Lp（a）病理生物学和新陈代谢的机械过程是一个持续的挑战。此外，Lp（a）的复杂结构为准确量化血浆浓度提供了主要障碍，并且需要一种普遍接受的标准化方法来测量Lp（a）。在选择性降低Lp（a）的新型疗法的开发中已取得重大进展。然而，在这些疗法可以广泛实施之前，需要进一步的研究以评估其在预防心血管事件中的功效，安全性和成本效益。我们回顾了Lp（a）的分子和生物化学方面，流行病学和病理生物学的最新进展，并提供了有关Lp（a）在临床医学中的意义的当代更新。预防心血管事件的安全性和成本效益。我们回顾了Lp（a）的分子和生物化学方面，流行病学和病理生物学的最新进展，并提供了有关Lp（a）在临床医学中的意义的当代更新。预防心血管事件的安全性和成本效益。我们回顾了Lp（a）的分子和生物化学方面，流行病学和病理生物学的最新进展，并提供了有关Lp（a）在临床医学中的意义的当代更新。

“进步不在于增强现状，而在于向未来发展。” （Khalil Gibran）