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Published on: October 12, 2017
High prevalence of raised lipoprotein(a) in patients with refractory angina
Tina Z Khan1, Samantha Rhodes1, Alison Pottle1
1Harefield Hospital, London, United Kingdom.
Insights
A high prevalence of elevated lipoprotein(a) [Lp(a)] was found in patients with refractory angina. This suggests Lp(a) may play a role in this condition, warranting further investigation into potential treatments.
Area of Science:
- Cardiology
- Lipidology
- Atherosclerosis Research
Background:
- Refractory angina, difficult to treat with standard therapies, significantly impacts patients.
- Elevated lipoprotein(a) [Lp(a)] is a recognized cardiovascular risk factor.
- The prevalence of high Lp(a) in refractory angina patients was previously undefined.
Purpose of the Study:
- To determine the prevalence of elevated lipoprotein(a) [Lp(a)] levels (>500 mg/L) in patients suffering from refractory angina.
Main Methods:
- A pilot epidemiological screening study involved 75 refractory angina patients from a UK tertiary cardiac center.
- Lipoprotein(a) [Lp(a)] levels were measured using an isoform-insensitive assay.
- Fasting lipid profiles and conventional cardiovascular risk factors were also assessed.
Main Results:
- 60% of the 75 refractory angina patients exhibited elevated Lp(a) levels (>500 mg/L).
- The median Lp(a) level was 771 mg/L, with an interquartile range of 162-1260 mg/L.
Conclusions:
- The high prevalence of elevated Lp(a) in this cohort suggests a potential causal role in refractory angina.
- Further research, including prospective studies, is needed to confirm this association and explore Lp(a) reduction therapies.
Background:
Angina that is refractory to conventional medical therapy and revascularisation, remains challenging to manage and poses significant burden to patients. Elevated lipoprotein(a) [Lp(a)] has emerged as an important independent cardiovascular risk factor and predictor of adverse outcomes in atherosclerotic disease. The prevalence of raised Lp(a) amongst patients with refractory angina has not yet been defined.
Objective:
To establish the prevalence of raised [Lp(a)] >500 mg/L in patients with refractory angina.
Methods:
We conducted an epidemiological screening pilot study in 75 patients with refractory angina from a UK tertiary cardiac centre. We determined the proportion of the cohort with raised Lp(a) >500 mg/L using an isoform-insensitive method. In addition, a full fasting lipid profile (including: LDL cholesterol, HDL cholesterol, total cholesterol to HDL ratio and triglycerides) was obtained. Patients were also asked about the presence of conventional cardiovascular risk factors.
Results:
Our study demonstrated that 60% of the 75 patients with refractory angina had raised Lp(a) levels of >500 mg/L. The median and inter-quartile range of Lp(a) values were 771 mg/L (162 mg/L,1260 mg/L) respectively.
Conclusions:
This high prevalence of raised Lp(a) detected in our cohort with refractory angina may suggest a causal role. Further research is necessary to confirm this association and prospective studies are needed to explore the potential therapeutic benefit of Lp(a) reduction in patients with refractory angina.
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