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preLekára.sk / Journals / Internal Medicine / 2018 - 12

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

Česká verzia

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

Summary

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

Zdroje
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Štítky
Diabetology Endocrinology Internal medicine
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Článek Comments on the most important and recent studies involving PCSK9i
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Článek Bilirubin: from an unimportant waste product to important myocardial infarction predictor
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Článek Current views on metabolic syndrome
Článek Why not to interfere with LDL-cholesterol freefall and why not to talk badly about statins
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Článek PCSK9 inhibitors and diabetes mellitus
Článek The changes in cardiovascular prevention practice between 1995–2017 in the Czech Republic: a comparison of EUROASPIRE I, II, III, IV and V study
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Internal Medicine

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