Effect of Aspirin Treatment on Serum Concentrations of Lipoprotein(a) in Patients with Atherosclerotic Diseases

Abstract

Background: Increased serum lipoprotein(a) [Lp(a)] is an independent risk factor for atherosclerosis. We previously reported that aspirin reduced Lp(a) production by cultured hepatocytes via the reduction of apolipoprotein(a) [apo(a)] gene transcription. Methods: We evaluated both the effect of aspirin treatment (81 mg/day) on serum Lp(a) concentrations and the correlation between the degree of reduction in serum Lp(a) and the type of apo(a) isoform in 70 patients with coronary artery disease or cerebral infarction. Results: Aspirin lowered serum Lp(a) concentrations to ∼80% of the baseline values in patients with high Lp(a) concentrations (>300 mg/L). The percentage of decrease in serum Lp(a) was larger in patients with high Lp(a) than in patients with low Lp(a) (<300 mg/L), irrespective of apo(a) isoform size. The decreases in serum Lp(a) in high Lp(a) patients with both the high-molecular-weight and the low-molecular-weight isoforms were positively correlated with the baseline Lp(a) concentrations. Conclusions: Because the secretory efficiencies of apo(a) in the same isoform are likely to be similar, the difference in serum Lp(a) concentrations in patients having the same apo(a) isoform depends on the transcriptional activity of the apo(a) gene. These findings suggest that aspirin decreases serum Lp(a) concentrations via a decrease in apo(a) gene transcription more effectively in patients with high transcriptional activity of this gene.

HEART UK consensus statement on Lipoprotein(a): A call to action

“…Further prospective studies investigating the effect of aspirin in patients with elevated Lp(a) are warranted. Aspirin may also reduce Lp(a) levels by reducing apo(a) expression [76] although the evidence for this has come from very small studies [77] and requires confirmation.…”

Antioxidative Action of Aspirin on Endothelial Function in Hypercholesterolaemic Rats

“…Akaike et al . [33] demonstrated that aspirin lowers serum lipoprotein(a) concentration, an independent risk factor for atherosclerosis, potentially through the reduction in apolipoprotein(a) gene transcription in patients with high serum lipoprotein(a). The hypolipidaemic potential of aspirin in hypercholesterolaemia could also be due to its antioxidant activity as evident from a significant fall in LDL‐C and an increase in HDL‐C in the aspirin‐treated group of rats as observed in this study and also by others, in which aspirin reduced blood cholesterol level by its potential antioxidative activity [34].…”

Lipoprotein (a) in Chronic Renal Failure: Effect of Maintenance Hemodialysis

“…Nicotinic acid has been found to have a beneficial effect on Lp(a) levels; however, it is difficult to use because of its side effects [34]. Recently, Akaike et al [35] have demonstrated that low-dose aspirin treatment decreases Lp(a) level in patients with elevated Lp(a) levels irrespective of Apo(a) isoform size. They suggested that aspirin decreases Lp(a) concentration via a decrease in Apo(a) gene transcription.…”