Lipoprotein(a) is a still largely unknown LDL-cholesterol like molecule. It is, however, the most frequent inherited risk factor for heart attack, stroke, and calcific aortic valve disease. Lipoprotein(a), also known as Lp(a), is inherited in 20–30% of populations tested suggesting that it is elevated in over 1.5 billion people worldwide. Reports on Lp(a) are available in the research and lay press and a book has been published on the topic this year.
A unique feature of Lp(a) is that, in addition to its pro-atherosclerotic and pro-inflammatory potential, it also promotes blood clotting. Studies have evaluated if persons who inherit Lp(a) are at more risk of blood clots in the legs, lungs and other sites. An increased frequency of Lp(a) in persons suffering these serious conditions has been reported. An elevated level of Lp(a) in stroke patients increased the risk 12 fold for a deep venous thrombosis in one study.
COVID-19 and Hypercoagulability
An unexpected aspect of patient care during the current pandemic with COVID-19 infections is the frequent finding of aggressive blood clotting in arterial and venous circulations. A unique coagulopathy has been identified and recently reviewed. Some COVID-19 patients seriously ill and die due to rampant clotting in vital organs. The gripping fight for survival by Broadway star Nick Cordero, and his need to have a leg amputated apparently due in part to vascular compromise and clotting, has captured many hearts and minds in the media.
Lipoprotein(a) and COVID-19
To date, there are no published reports examining whether levels of Lp(a) are elevated in patients fighting COVID-19 who experience clotting complications. However, two organizations have provided comments on the possibility that this possible connection should be considered. The FH Foundation has added a section on their website indicating that many patients with Familial Hyperlipidemia (FH) also have an elevated Lp(a) and may be at risk for clotting disorders if infected. In addition, the Lipoprotein(a) Foundation has added comments on their website. This included a letter by S. Tsimikas, MD, of the University of California San Diego and noted researcher on Lp(a). He indicates in the letter that an inflammatory mediator, IL-6, is increased in the cytokine storm that can develop during a COVID-19 infection. IL-6 can also increase levels of Lp(a) raising the…