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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
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Current views on metabolic syndrome
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Article was published in

Internal Medicine

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