Pathophysiological, epidemiological, and genetic studies provide strong evidence that lipoprotein(a) [Lp(a)] is a causal mediator of cardiovascular disease (CVD) and calcific aortic valve disease (CAVD). Specific therapies to address Lp(a)-mediated CVD and CAVD are in clinical development. Due to knowledge gaps, the National Heart, Lung, and Blood Institute organized a working group that identified challenges in fully understanding the role of Lp(a) in CVD/CAVD. These included the lack of research funding, inadequate experimental models, lack of globally standardized Lp(a) assays, and inadequate understanding of the mechanisms underlying current drug therapies on Lp(a) levels. Specific recommendations were provided to facilitate basic, mechanistic, preclinical, and clinical research on Lp(a); foster collaborative research and resource sharing; leverage expertise of different groups and centers with complementary skills; and use existing National Heart, Lung, and Blood Institute resources. Concerted efforts to understand Lp(a) pathophysiology, together with diagnostic and therapeutic advances, are required to reduce Lp(a)-mediated risk of CVD and CAVD.

中文翻译：

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NHLBI 工作组关于降低脂蛋白 (a) 介导的心血管疾病和主动脉瓣狭窄风险的建议

病理生理学、流行病学和遗传学研究提供了强有力的证据，证明脂蛋白 (a) [Lp(a)] 是心血管疾病 (CVD) 和钙化性主动脉瓣疾病 (CAVD) 的致病介质。针对 Lp(a) 介导的 CVD 和 CAVD 的特定疗法正在临床开发中。由于知识差距，国家心肺血液研究所组织了一个工作组，确定在充分理解 Lp(a) 在 CVD/CAVD 中的作用方面存在的挑战。其中包括缺乏研究资金、实验模型不足、缺乏全球标准化的 Lp(a) 检测，以及对当前药物治疗 Lp(a) 水平的机制理解不足。提供了具体建议以促进 Lp(a) 的基础、机制、临床前和临床研究；促进合作研究和资源共享；利用具有互补技能的不同团体和中心的专业知识；并使用现有的国家心肺血液研究所资源。需要共同努力了解 Lp(a) 病理生理学，连同诊断和治疗进展，以降低 Lp(a) 介导的 CVD 和 CAVD 风险。