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proLékaře.cz / Journals / Internal Medicine / 2018 - 12

Lipoprotein(a) – the cardiovascular risk factor: significance and therapeutic possibilities

Czech version

Authors: Vladimír Bláha
Authors‘ workplace: III. interní gerontometabolická klinika LF UK a FN Hradec Králové
Published in: Vnitř Lék 2018; 64(12): 1160-1168
Category:

Overview

About 20 % of the population has raised Lp(a) concentrations and evidence suggests that high levels of Lp(a) are an independent cardiovascular risk factor. Both the European Society of Cardiology and the European Atherosclerosis Society recommend measuring Lp(a) values in intermediate to high-risk patients for risk stratification, as well as in patients already under statin treatment and with recurrent clinical events as a residual risk factor that calls for lipid-lowering therapy intensification. Strategies used to lower Lp(a) concentrations have either been partially disappointing in the past or lack cardiovascular outcome data. Therefore, Lp(a) has often been considered as a nonmodifiable cardiovascular risk factor. New and consistent data retrieved from the PCSK9 inhibitor trials now suggest that Lp(a) can be decreased effectively by roughly 30 %, while emerging data from apo(a) antisense therapy trials suggest that selective and potent Lp(a) reduction is a feasible treatment approach in the future. The impact of such decreases on the occurrence of cardiovascular outcomes, independent from LDL-C, could, if established, herald Lp(a) in the treatment of atherosclerosis.

Key words:

alirocumab – atherosclerosis – cardiovascular disease – evolocumab – hypercholesterolaemia – lipoprotein(a) – lipoprotein apheresis

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Labels
Diabetology Endocrinology Internal medicine
A summary of the EAS consensus concerning the causal relationship between low-density lipoproteins and atherosclerotic cardiovascular diseases, prepared by the Board of the Czech Society for Atherosclerosis
Consensus statement of professional associations on prescribing of PCSK9-inhibitors
Comments on the most important and recent studies involving PCSK9i
Inflammation and atherosclerosis
Bilirubin: from an unimportant waste product to important myocardial infarction predictor
“The higher the better” seems to be no longer true for HDL-cholesterol
Current views on metabolic syndrome
Why not to interfere with LDL-cholesterol freefall and why not to talk badly about statins
Combined lipid-lowering therapy
PCSK9 inhibitors and diabetes mellitus
The changes in cardiovascular prevention practice between 1995–2017 in the Czech Republic: a comparison of EUROASPIRE I, II, III, IV and V study
Article was published in

Internal Medicine

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2018 Issue 12
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