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Lipoprotein(a)-an interdisciplinary challenge.

U Julius1, S Tselmin2, U Schatz2

  • 1Lipidology and Center for Extracorporeal Treatment, Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany. ulrich.julius@uniklinikum-dresden.de.

Clinical Research in Cardiology Supplements
|March 7, 2019
PubMed
Summary
This summary is machine-generated.

High lipoprotein(a) [Lp(a)] is an inherited cardiovascular risk factor. While lipoprotein apheresis is effective, optimizing other risk factors is key, with new therapies on the horizon.

Keywords:
Cardiovascular eventsLDL cholesterolLipoprotein apheresisPCSK9 inhibitorsPhysicians

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Area of Science:

  • Cardiology
  • Genetics
  • Metabolic Disorders

Background:

  • Lipoprotein(a) [Lp(a)] is an inherited, potent atherogenic risk factor.
  • Elevated Lp(a) levels are not currently a primary indication for treatment despite their association with cardiovascular events (CVE).
  • Lp(a) levels are resistant to lifestyle modifications like diet and exercise.

Purpose of the Study:

  • To outline the management strategies for patients with elevated Lp(a).
  • To emphasize the collaborative roles of various medical specialists in patient care.
  • To discuss current and future therapeutic options for reducing Lp(a)-associated cardiovascular risk.

Main Methods:

  • Review of current literature on Lp(a) and its management.
  • Discussion of therapeutic interventions including PCSK9 inhibitors, lipoprotein apheresis (LA), and emerging antisense oligonucleotides.
  • Emphasis on optimizing secondary risk factors such as LDL cholesterol, hypertension, and diabetes mellitus.

Main Results:

  • Lipoprotein apheresis (LA) is highly effective in lowering Lp(a) and reducing CVE.
  • PCSK9 inhibitors offer a modest reduction in Lp(a) for some patients.
  • Future therapies, including antisense oligonucleotides targeting apolipoprotein(a), are anticipated.

Conclusions:

  • Measurement of Lp(a) is recommended for high-risk individuals.
  • Multidisciplinary care involving family doctors, specialists, and lipidologists is crucial.
  • Optimizing all modifiable cardiovascular risk factors remains a cornerstone of management for patients with elevated Lp(a).