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LAICON 2022: International - Lp(a) and CVD

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Dr Kris Vijay, USA    02 January 2023

 

  • High levels of lipoprotein are an independent causal risk factor for ASCVDs.
  • Mechanisms include increased atherogenesis, inflammation and thrombosis.
  • Lipoprotein(a) [Lp(a)] is predominantly a monogenic CV risk determinant, with =70% to ≥90% of interindividualized heterogeneity in levels being genetically determined.
  • The two major protein components of Lp(a) particles are apoB100 and apolipoprotein (a).
  • Lp(a) remains a risk factor for CVD development even in the setting of effective reduction of plasma LDL-C and apoB100.
  • Despite its demonstrated contribution to ASCVD burden, we presently lack standard and harmonization of assays, universal guidelines for diagnosing and providing risk assessment, and targeted treatments to lower Lp(a).
  • There is a clinical need to understand the genetic and biological basis for variation in Lp(a) levels and its relationship to disease in different ancestry groups.
  • Lipoprotein apheresis is approved for reduction of levels if Lp(a) is >60 mg/dL.
  • New targeted therapies will hopefully provide insights into the prevention of ASCVD. 

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