Recommendations of the Experts of the Polish Cardiac Society (PCS) and the Polish Lipid Association (PoLA) on the diagnosis and management of elevated lipoprotein(a) levels

Archives of Medical Science, Journal Year: 2024, Volume and Issue: 20(1), P. 8 - 27

Published: Jan. 30, 2024

Lipoprotein(a) [Lp(a)] is made up of a low-density lipoprotein (LDL) particle and specific apolipoprotein(a). The blood concentration Lp(a) approximately 90% genetically determined, the main genetic factor determining levels size apo(a) isoform, which determined by number KIV2 domain repeats. isoform inversely proportional to Lp(a). strong independent cardiovascular risk factor. Elevated ≥ 50 mg/dl (≥ 125 nmol/l) are estimated occur in more than 1.5 billion people worldwide. However, determination performed far too rarely, including Poland, where, fact, it only since 2021 guidelines Polish Lipid Association (PoLA) five other scientific societies that measurements have begun be performed. Determination concentrations not easy due to, among things, different sizes isoforms; however, currently available certified tests make possible distinguish between with low high degree precision. In 2022, first for management patients elevated lipoprotein(a) were published European Atherosclerosis Society (EAS) American Heart (AHA). result work experts from two their aim provide clear, practical recommendations levels.

Language: Английский

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2023: The year in cardiovascular disease - the year of new and prospective lipid lowering therapies. Can we render dyslipidemia a rare disease by 2024?

Archives of Medical Science, Journal Year: 2023, Volume and Issue: unknown

Published: Nov. 1, 2023

In 2023 there are still even 75% of patients over the target low-density lipoprotein cholesterol (LDL-C), and hypercholesterolemia is most common worst monitored cardiovascular risk factor. How it possible, considering knowledge we have on role in process atherosclerosis, atherosclerotic disease (ASCVD) its complications, methods lipid disorders diagnosis, prevention, treatment. Nowadays, almost 4 million deaths per year attributed to LDL-C, 2/3 all CVD ASCVD, therefore hypothetically should easily prevent few several with early intensive non-pharmacological pharmacological therapies. Moreover, lipidology now, besides oncology, area highest number new ongoing trials effective safe medications that already appeared will soon be available. Therefore, no doubt called prospective lowering therapies (LLTs). this State-of-the-Art paper summarized important trials, studies, recommendations LLTs, suitable graphical summaries might helpful for physicians their practice a look nearest future being under investigation. Let's hope those helps render dyslipidemia rare next years.

Language: Английский

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Association between Lipoprotein(a) and premature atherosclerotic cardiovascular disease: a systematic review and meta-analysis

European Heart Journal Open, Journal Year: 2024, Volume and Issue: 4(3)

Published: April 26, 2024

Abstract Aims High lipoprotein(a) [Lp(a)] level has been demonstrated as an important risk factor for atherosclerotic cardiovascular diseases (ASCVD) amongst the older populations, whereas its effects in younger population remain unclear. This study evaluated associations between Lp(a) and of premature ASCVD. Method results PubMed Embase were searched related studies until 12 November 2023. Fifty-one including 100 540 participants included. Mean age patients ranged from 35.3 to 62.3 years. The proportion male 0% 100%. mean follow-up was provided five ranging 1 year 40 definition elevated varied among studies, such >30 mg/dL, >50 top tertiles, quartiles, quintiles, so on. Higher significantly associated with composite ASCVD [odds ratio (OR): 2.15, 95% confidence interval (95% CI): 1.53–3.02, P < 0.001], especially coronary artery disease (OR: 2.44, CI: 2.06–2.90, 0.001) peripheral arterial 2.56, 1.56–4.21, 0.001). association remained significant familial hypercholesterolaemia (FH) 3.11, 1.63–5.96, type 2 diabetes mellitus (T2DM) 2.23; 1.54–3.23, 0.001).Significant observed South Asians 3.71, 2.31–5.96, 0.001), Caucasians 3.17, 2.22–4.52, baseline low-density lipoprotein cholesterol (LDL-c) ≥ 2.6 mmol/L. Conclusion Elevated predicts or individual young, regardless design, gender, characteristics (community hospitalized), different definitions, various measurement approaches. Asians, Caucasians, FH patients, T2DM LDL-c

Language: Английский

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Lifestyle and Lipoprotein(a) Levels: Does a Specific Counseling Make Sense?

Journal of Clinical Medicine, Journal Year: 2024, Volume and Issue: 13(3), P. 751 - 751

Published: Jan. 28, 2024

Lipoprotein(Lp)(a) is a variant of low-density lipoprotein (LDL), bound to apolipoprotein B100, whose levels are associated with significant increase in the risk atherosclerosis-related cardiovascular events, but also aortic stenosis and atrial fibrillation. Since plasma Lp(a) commonly considered resistant lifestyle changes, we critically reviewed available evidence on effect weight loss, dietary supplements, physical activity this factor. In our review, observed that relevant body relatively high intake saturated fatty acids, consumption red wine, intense exercise seems be significantly lower levels. On contrary, foods rich trans-unsaturated acids increased With regard coenzyme Q10, L-Carnitine, flaxseed exert mild lowering Lp(a).

Language: Английский

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Lipoprotein(a) and its impact on cardiovascular disease – the Polish perspective: Design, and first results of the Zabrze-Lipoprotein(a) Registry

Archives of Medical Science, Journal Year: 2024, Volume and Issue: 20(4), P. 1069 - 1076

Published: May 6, 2024

Introduction Lipoprotein(a) [Lp(a)] is an independent risk factor for atherosclerotic cardiovascular disease (ASCVD). Increased Lp(a) concentration > 30 mg/dl (75 nmol/l) and especially >50 (125 may cause faster atherosclerosis, being important underdiagnosed residual factor. Thus, there a need to characterize further the clinical phenotypes in patients at ASCVD with high levels now during follow-up, while also looking possible impact of geographical differences. Material methods The Zabrze Registry (Zabrze-Lip(a)R) was founded on basis data from 2,001 consecutive very treated tertiary hospital. registry will be followed least 5 years possibility extending this period as open label study. All-cause cause-specific mortality, hospitalizations, events, such myocardial infarction (MI) stroke, assessed. Results mean age 66.4 (females 37.1%). median entire population 6.6 (16.5 (mean: 14.3 ±19.4 mg/dl). 540 (27%) had elevated above nmol/l); they were significantly older (68.8 vs. 66.3 years; p = 0.04), lower hemoglobin hematocrit, higher platelet count NT-proBNP C-reactive protein. prevalence concentrations chronic coronary syndrome (CCS) (52.2% (282/540) 41.5% (607/1461); < 0.001), undergoing PCI hospitalization (23.9 19%; 0.01), previous MI (20.6% 14.9%; 0.0022). In multivariable analysis, predictors only Hb values (OR 0.925; 95% CI: 0.874–0.978; 0.006) (1.002; 95%CI: 1.000–1.003; 0.02). Conclusions Poland, largest representative Central Eastern European countries, 27% established experience additional related level, every second patient having CCS. Interestingly, two factors levels: count. However, relevance these results needs confirmation.

Language: Английский

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The prevalence, patients' characteristics, and hyper-Lp(a)-emia risk factors in the polish population. The first results from the PMMHRI-Lp(a) registry

Progress in Cardiovascular Diseases, Journal Year: 2024, Volume and Issue: 86, P. 54 - 61

Published: Aug. 25, 2024

The knowledge on the prevalence of elevated lipoprotein(a) (Lp(a)), patients' characteristics, and nongenetic risk factors is scarce in some regions including Poland, largest Central Eastern European country. Thus, we aimed to present results from Lp(a) registry established Poland's 2nd largest, supra-regional hospital - Polish Mother's Memorial Hospital Research Institute (PMMHRI).

Language: Английский

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Causal associations between insulin and Lp(a) levels in Caucasian population: a Mendelian randomization study

Cardiovascular Diabetology, Journal Year: 2024, Volume and Issue: 23(1)

Published: Aug. 29, 2024

Numerous observational studies have demonstrated that circulating lipoprotein(a) [Lp(a)] might be inversely related to the risk of type 2 diabetes (T2D). However, recent Mendelian randomization (MR) do not consistently support this association. The results in vitro research suggest high insulin concentrations can suppress Lp(a) levels by affecting apolipoprotein(a) [apo(a)] synthesis. This study aimed identify relationship between genetically predicted and levels, which may partly explain associations low increased T2D.

Language: Английский

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Position paper of the Polish Expert Group on the use of pitavastatin in the treatment of lipid disorders in Poland endorsed by the Polish Lipid Association

Archives of Medical Science, Journal Year: 2023, Volume and Issue: 20(1), P. 28 - 42

Published: Nov. 26, 2023

Lipid disorders, primarily hypercholesterolemia, are the most common cardiovascular (CV) risk factor in Poland (this applies even 3/4 of people). The low-density lipoprotein cholesterol (LDL-C) serum level is basic lipid parameter that should be measured to determine CV and determines aim target lipid-lowering treatment (LLT). Lipid-lowering improves prognosis prolongs life both primary secondary prevention. Despite availability effective drugs solid data on their beneficial effects, LDL-C control highly insufficient. This related, among other things, physician inertia patients’ fear side effects. development lipidology has made available with a good safety profile enabling personalisation therapy. Pitavastatin, third potent statin, characterised by lower muscle complications new cases diabetes due its being metabolised differently. Thus, pitavastatin very therapeutic option patients at high or existing diabetes, risk. expert opinion paper attempts recommendation place possibility using disorders.

Language: Английский

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Estimating the Prevalence and Characteristics of Patients Potentially Eligible for Lipoprotein(a)-Lowering Therapies in a Real-World Setting

Biomedicines, Journal Year: 2023, Volume and Issue: 11(12), P. 3289 - 3289

Published: Dec. 12, 2023

High lipoprotein(a) (Lp(a)) plasma levels are significantly associated with an increased risk of developing atherosclerotic cardiovascular diseases (ASCVD). The aim this analysis was to estimate the prevalence and characteristics patients potentially eligible for Lp(a)-lowering therapies in a real-world setting (i.e., ASCVD Lp(a) > 70 mg/dL). For reason, we pooled data from large cohort Italian outpatients (N = 5961; men: 2879, women: 3982) dyslipidemia. A binary logistic regression used determine significant predictors cohort, which were age (Odds Ratio (OR): 1.158, 95% Confidence Interval (CI): 1.114 1.203,

Language: Английский

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The Effects of Glucagon-Like Peptide-1 Receptor Agonists on Atherosclerotic Plaque: Cytokine Profile in Diabetic Individuals

Authorea (Authorea), Journal Year: 2024, Volume and Issue: unknown

Published: March 29, 2024

Introduction: Type 2 diabetes mellitus (T2DM) represents one of the most pressing global health challenges. The diabetic population has surged dramatically, from 108 million in 1980 to an estimated 529 2021. Hyperglycemia is intricately linked with endothelial dysfunction, which contributes development atherosclerosis, thereby increasing risk cardiovascular diseases. Atherosclerotic disease (ASCVD) closely associated vulnerable plaques, influenced by numerous cytokines. Consequently, contemporary treatments must consider pleiotropic effects that mitigate risk. Objectives: This study aimed investigate impact glucagon-like peptide-1 receptor agonists (GLP-1 RAs) on biomarkers indicative atherosclerotic plaque instability, including pentraxin 3 (PTX3), copeptin (CPC), matrix metalloproteinase-9 (MMP-9), and lipoprotein(a) [Lp(a)]. Patients Methods: Fifty subjects aged 41–81 years (mean: 60.7) diagnosed T2DM (median HbA1c: 8.75%), dyslipidemia, confirmed atherosclerosis via B-mode ultrasound were included. All eligible initiate treatment a GLP-1 RA. Results: Following 180-day intervention RAs, our observed statistically significant decrease biochemical markers PTX3, CPC, MMP-9 (p < 0.001), as well Lp(a) 0.05). Conclusions: significantly reduce concentrations MMP-9, Lp(a), all implicated vulnerability. effect may contribute reduction among patients.

Language: Английский

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