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Understanding serum lipids is crucial for maintaining cardiovascular health and preventing heart disease and stroke.
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Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
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Coronary Artery Disease IV: Preventive Measures01:26

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Effective preventive measures for coronary artery disease (CAD) focus on controlling modifiable risk factors, including cholesterol abnormalities and lifestyle changes.Cholesterol ManagementFirst, the Mediterranean diet and the American Heart Association advocate for maintaining low-density lipoprotein (LDL) cholesterol levels below 100 mg/dL, with a more stringent recommendation of below 70 mg/dL for individuals at high risk. LDL cholesterol, often termed "bad cholesterol," can lead to the...
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Hyperlipidemia, a medical condition often referred to as high cholesterol, is characterized by abnormally elevated levels of lipids in the bloodstream. When present in excess, these lipids, specifically cholesterol and triglycerides, can lead to serious health complications, often involving cardiovascular diseases. Illnesses like atherosclerosis, heart attacks, and pancreatitis have all been linked to untreated hyperlipidemia. This means controlling and regulating cholesterol and triglyceride...
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Lipids are an essential component of a balanced human diet. Triglycerides, which make up the majority of dietary lipids, are found in both saturated fats—commonly present in meat, dairy products, and certain tropical plants like coconut, and hydrogenated oils such as margarine and baking shortenings (trans fats)—and unsaturated fats, which are abundant in seeds, nuts, olive oil, and most vegetable oils. The main sources of cholesterol include egg yolks, various meats and organ...
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Considerations for routinely testing for high Lp(a).

Nick S Nurmohamed1,2, Patrick M Moriarty3, Erik S G Stroes1

  • 1Department of Vascular Medicine, Amsterdam UMC, University of Amsterdam, The Netherlands.

Current Opinion in Lipidology
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Summary
This summary is machine-generated.

Measuring Lipoprotein(a) (Lp[a]) is crucial for identifying individuals at high risk for atherosclerotic cardiovascular disease (ASCVD). New therapies targeting Lp(a) show significant reductions, offering hope for improved patient outcomes.

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Area of Science:

  • Cardiology
  • Genetics
  • Pharmacology

Background:

  • Lipoprotein(a) (Lp[a]) is a confirmed causal risk factor for atherosclerotic cardiovascular disease (ASCVD) and aortic valve disease.
  • A linear association exists between Lp(a) levels and ASCVD risk, established through reliable assays.
  • Existing low-density lipoprotein cholesterol (LDL-C) therapies have minimal impact on Lp(a) levels.

Purpose of the Study:

  • To review the clinical significance of Lp(a) measurement.
  • To discuss the therapeutic implications of targeting Lp(a) for ASCVD risk reduction.

Main Methods:

  • Review of current literature on Lp(a) and its role in cardiovascular disease.
  • Examination of emerging RNA-based therapeutic strategies for lowering Lp(a).

Main Results:

  • RNA-based therapies, including pelacarsen (antisense oligonucleotide) and olpasiran (small interfering RNA), demonstrate substantial Lp(a) reductions (up to 90%).
  • Phase 3 trials for pelacarsen are ongoing, and phase 2 trials for olpasiran are underway, showing dose-dependent efficacy.
  • Lp(a) is positioned as a key target for managing residual cardiovascular risk.

Conclusions:

  • Routine Lp(a) measurement is recommended for all patients at least once to identify those with elevated levels.
  • Patients with very high Lp(a) may benefit from future Lp(a)-lowering therapies.
  • Current management for patients with high Lp(a) should prioritize optimizing LDL-C reduction and addressing other ASCVD risk factors.