Lipoprotein(a): Solving the puzzle, deciphering the riddle, unraveling the enigma.

Over 20 years ago, my friend and colleague, Allan Sniderman, described lipoprotein(a)’s (Lp[a]) role in atherogenesis as a “puzzle inside a riddle within an enigma”, paraphrasing Sir Winston Churchill’s famous quote about Russia. 1 Sniderman A.D. Lipoprotein(a) and atherogenesis: a puzzle inside a riddle within an enigma. Clin Invest Med. 2002 Jun; 25: 89-91 PubMed Google Scholar In those intervening 20 years, Lp(a) has seen quite the renaissance, with compelling new evidence in favor of its fundamental role in atherosclerosis and cardiovascular disease. But how far have we come? Has the puzzle been totally solved? Has the riddle been completely deciphered? Have we completely unravelled the enigma that is Lp(a)? Lipoprotein(a) and the Effect of Alirocumab on Revascularization After Acute Coronary SyndromeCanadian Journal of CardiologyPreviewMany patients require revascularization after index acute coronary syndrome (ACS). Lipoprotein(a) is thought to play a pathogenic role in atherothrombosis. In ODYSSEY OUTCOMES, alirocumab reduced major adverse cardiovascular events after ACS, with greater reduction among those with higher lipoprotein(a) levels. We explored whether risk of revascularization after ACS was modified by the level of lipoprotein(a) and treatment with alirocumab or placebo. Full-Text PDF Open Access