Lipoprotein(a treatment)

What is the treatment for elevated lipoprotein? How is lipoprotein determined? This treatment should only be considered in those with recurrent CVD despite optimal control of other risk factors.

Research on Lp(a) suggests it has added value in preventive medicine, and it is time for cardiologists and cardiovascular team members to consider using it routinely in their practice. The current simplest treatment for elevated Lp (a) is to take 1–grams of niacin daily , typically in an extended-release form.

Niacin therapy may reduce Lp (a) levels by 20–. In the past, we have been able to inform patients of their levels of lipoprotein(a), however, it was very difficult to provide any effective treatment. Cholesterol treatments such as statins did not reveal any beneficial at lowering levels of lipoprotein (a).

Low-density lipoprotein (LDL), or “bad cholesterol,” is typically associated with an increased risk of heart attack and stroke. Lipoproteins are substances made up of protein and fat. Examples include low-density lipoprotein , which carries “bad cholesterol” and high-density lipoprotein , which carries “good cholesterol”.

It contains LDL and a protein called apolipoprotein(a) (not to be confused with apoA). Treatment of Lp (a) Levels of Lp(a) do not change throughout life and are usually unaffected by lifestyle or environment.

Effects of medications: commonly prescribed lipid lowering medication such as statins have little effect on Lp(a). The lipoproteins vary in the major lipoprotein present and the relative contents of the different lipid components. Like LDL particles, Lp( a ) increases atherosclerosis by inflammation and pro-oxidation. Finally, there are a number of Lp(a) lowering medications in clinical trials now. Recent epidemiologic and Mendelian randomization studies have provided evidence that Lp(a) is causally related to the pathogenesis of atherosclerosis and cardiovascular disease (CVD).

Continuing high LDL levels despite receiving aggressive treatment Should You Try to Lower Your Levels? Unfortunately, because lipoprotein (a) levels are mainly influenced by your genes, the usual recommendations — a healthy diet, regular exercise, and (most) cholesterol-lowering medications — do not have much effect on lowering them. LDL also has one apolipoprotein B protein attached to it, as does Lp (a). Mipomersen, an antisense oligonucleotide, is a new agent that lowers both Lp( a ) and LDL by inhibiting synthesis of apolipoprotein B. However, despite its positive effects on Lp(a) as well as the conventional lipoprotein traits LDL-C, HDL-C, and triglycerides, nicotinic acid was not found to reduce cardiovascular risk more than statin treatment , so it is not recommended for preventive treatment. Fibrates have no effect on Lp(a).

Mainstay of treatment is a fat-free diet. Apo Cinhibits lipoprotein lipase and hepatic lipase. Increased apo Cexpression may lead to hypertriglyceridaemia and an atherogenic lipoprotein profile. Two susceptibility haplotypes (P2-S2-Xand P1-S2-X1) have been discovered in apo A1-C3-Agene cluster on chromosome 11q23. Randomized controlled studies that investigate the effect of selectively lowering Lp ( a ) on atherosclerotic cardiovascular disease are needed.

It’s estimated that.

Lp(a) is not considered a treatment target and repeat measures are not indicated. Canadian Cardiovascular Society Guidelines for the Management of Dyslipidemia for the Prevention of Cardiovascular Disease in the Adult here. Lp (a) may be requested with other lipid tests in patients who have developed cardiovascular disease at a young age or who have a family history of premature heart disease to determine whether the concentration of Lp(a) is contributing to the patient’s risk of cardiovascular disease.

If you’re trying to lower your risk of developing heart disease, it’s best to put lipoprotein(a) on the treatment “back burner” for now and focus instead on methods for reducing the well-established risk factors for heart disease. Understanding a FH patients Lp(a) levels can aid the physician in identifying the patient’s risk of a cardiovascular event and in the evaluation of treatment methods. While most people know that low-density lipoprotein (LDL)-C, or bad cholesterol, can cause heart disease, relatively few people know about the risk posed by lipoprotein (a), or Lp(a).

Also referred to as “LP little a,” this type of lipoprotein is comprised of an LDL-like particle with a second protein, called apolipoprotein(a), or apo(a), coiled around it.