Lp(a) is a type of cholesterol that is the strongest genetic risk factor for heart disease. In Canada and Europe, a test is recommended for everyone, but not in the US, even though it could inspire those at risk to live healthier. 1/8 tinyurl.com/46reumcc
There are no effective drugs to treat high LP(a) but removing it from the blood stream using apheresis in high-risk patients can dramatically reduce major coronary events 2/8
In the LPA gene there is a repetitive part called kringle IV, lower numbers of which lead to increased Lp(a) concentrations (I have the bad version btw) 3/8
A common variant is at location rs10455872 at the LPA locus with an odds ratio for coronary disease of 1.70 (95% CI, 1.49 to 1.95) and another independent variant (rs3798220) with an odds ratio of 1.92 (95% CI, 1.48 to 2.49). If you’ve done @23andMe you can check it. 🧬 4/8
Both variants are strongly associated with an increased level of Lp(a) lipoprotein, a reduced copy number of the Kringle repeats, and a smaller particle size, which is more dangerous. 5/8 nejm.org/doi/full/10.10…
Most people have Lp(a) levels 5 to 29 mg/dL. The risk of heart disease may start to rise at 30 mg/dl (about 75 nmol/L), and it rises more steeply at levels of 50 mg/dL (about 125 nmol/L) and higher. An estimated one in seven people are at or above this threshold. 6/8
Statins do not reduce Lp(a) and seems to cause a slight increase. Niacin (vitamin B3) can provide modest reductions in Lp(a) but studies have failed to show that niacin reduces heart disease risk. 7/8 amgen.com/stories/2019/0…
A type of therapy called short interfering RNA (siRNA) is being developed to treat high Lp(a) and seems to work in small studies. In the meantime, eat well, eschew 3 main meals a day, exercise & definitely don’t smoke, especially if you have high Lp(a) levels 🥗✌️8/8
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