Pathological Analysis of Lipoprotein(a) Risk Variants and Culprit Coronary Thrombotic Lesions

CVPath’s research letter, led by Dr. Tatsuya Shiraki, was recently published in JAMA Cardiology. This paper examines the association between Lp(a) risk variants and coronary pathological findings in individuals with sudden coronary death. The authors found that Lp(a) risk variants were associated with increased prevalence of plaque rupture, and risk variant carriers showed greater Lp(a) accumulation in coronary plaques and thrombi. Thrombi in carriers showed higher cellular organization with reduced D-dimer, suggesting potential impairment of fibrinolysis. These findings support the rationale for Lp(a)-lowering therapies and may inform further drug development targeting Lp(a)-mediated thrombotic risk. The full paper can be found here.