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What are Lipids?01:38

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Differential Effects of Lipid-lowering Drugs in Modulating Morphology of Cholesterol Particles
09:15

Differential Effects of Lipid-lowering Drugs in Modulating Morphology of Cholesterol Particles

Published on: November 10, 2017

Lipoprotein (a): perspectives from a lipid-referral program.

Melvyn Rubenfire1, Deepthi Vodnala, Sangeetha M Krishnan

  • 1Division of Cardiovascular Medicine, University of Michigan, 24 Frank Lloyd Wright Drive, PO Box 322, Ann Arbor, MI 48188, USA. mrubenfi@umich.edu

Journal of Clinical Lipidology
|January 24, 2012
PubMed
Summary
This summary is machine-generated.

High lipoprotein (a) [Lp(a)] levels, linked to coronary heart disease (CHD), are more common in African-American women. Nearly 19% of moderate to high-risk patients could benefit from niacin therapy based on elevated Lp(a) levels.

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Last Updated: May 25, 2026

Differential Effects of Lipid-lowering Drugs in Modulating Morphology of Cholesterol Particles
09:15

Differential Effects of Lipid-lowering Drugs in Modulating Morphology of Cholesterol Particles

Published on: November 10, 2017

Area of Science:

  • Cardiology
  • Lipidology
  • Preventive Medicine

Background:

  • Elevated Lipoprotein (a) [Lp(a)] is strongly associated with coronary heart disease (CHD).
  • Assessing the utility of niacin therapy in patients with elevated Lp(a) and varying cardiovascular risk is crucial.
  • The Framingham Risk Score (FRS) is a common tool for stratifying cardiovascular risk.

Purpose of the Study:

  • To evaluate the implications of implementing a niacin treatment strategy in individuals at increased risk for cardiovascular disease, specifically those with elevated Lp(a) levels.
  • To identify factors associated with high Lp(a) levels and assess the proportion of patients eligible for niacin therapy based on specific Lp(a) cutpoints.

Main Methods:

  • Lipoprotein (a) [Lp(a)] levels were measured in 692 patients referred to a university lipid management program.
  • Multiple logistic regression was used to identify predictors of high Lp(a) (≥50 mg/dL).
  • Eligibility for niacin therapy was assessed using both the Framingham Risk Score (FRS) and Lp(a) levels.

Main Results:

  • African-American race, female gender, presence of CHD, and lower triglyceride levels were significant predictors of high Lp(a).
  • Of patients assessed, 10% were intermediate and 44% were high risk by FRS.
  • 19% of moderate and high-risk patients met criteria for niacin initiation based on Lp(a) ≥50 mg/dL, with 84% not currently on niacin.

Conclusions:

  • High-risk Lp(a) levels are significantly associated with female gender, African-American race, and existing CHD.
  • A substantial proportion (19%) of moderate to high-risk patients are candidates for niacin therapy when Lp(a) ≥50 mg/dL is used as an indication.
  • Niacin therapy could be considered for a defined group of patients with elevated Lp(a) to potentially mitigate cardiovascular risk.