Lipoprotein(a) or Lp(a) : What you Need To Know скачать в хорошем качестве

Lipoprotein(a) or Lp(a) : What you Need To Know

Lipoprotein(a) - Lipoprotein(a), or Lp(a), is one of the most important - and least discussed - genetic risk factors for heart attack, stroke, and aortic valve disease. I’ve now worked with countless families that have lost someone young to cardiovascular disease, only to later discover elevated Lp(a) was the missing explanation. This video introduces what Lp(a) is, why it’s dangerous, and why so many unexpected heart attacks happen in people who otherwise seemed healthy. Why Heart Attacks Happen and the role of Lp(a): Heart attacks occur when plaque builds up inside coronary arteries, becomes inflamed, and suddenly ruptures, triggering a clot. Lp(a) is uniquely harmful because it accelerates all three of these steps at once. Unlike LDL alone, Lp(a) deposits cholesterol, promotes inflammation, and actively encourages clot formation - making it a triple-threat for heart attack. How is Lp(a) different from LDL cholesterol: Lp(a) looks like LDL but carries an extra protein - apolipoprotein(a) - that makes it sticky, inflammatory, and pro-thrombotic. Large population studies show elevated Lp(a) independently increases heart attack risk 2 to 4×, raises stroke risk, and strongly contributes to calcific aortic valve stenosis (valve stiffness and dysfunction). Testing Lp(a) level: Because Lp(a) is genetic, levels are stable across life. That’s why (broadly) everyone should get at least one lifetime Lp(a) test, including children over age 5. Lower is always better. Levels above ~75 nmol/L (or ~29 mg/dL) are considered high, while levels over 200 nmol/L are often seen in people who experience events decades too early. Knowing your number allows proper risk stratification and prevention planning. What actually helps, and what doesn't: As of now, our best understanding is that lifestyle changes, supplements, and hormones do not meaningfully lower Lp(a) or change outcomes - despite what misinformation sources may claim. The evidence-based approach is aggressive risk reduction elsewhere: lowering ApoB and LDL (often with statins, ezetimibe, or PCSK9 inhibitors), controlling blood pressure and insulin resistance, addressing inflammation, and optimizing sleep, exercise, diet, and smoking cessation. Hope on the horizon: targeted Lp(a) therapies For the first time ever, medications designed specifically to dramatically reduce Lp(a) production are in advanced clinical trials. Antisense and siRNA therapies are showing 50 to 90% reductions in Lp(a) with promising safety data. Until these are available, understanding your risk, completing a full preventive workup, and using proven therapies can dramatically change the outcome. Learn More: Family Heart Foundation: https://familyheart.org/ Foundation of the National Lipid Association: https://www.learnyourlipids.com/ American Society of Preventive Cardiology: https://www.aspconline.org/ American Heart Association Lp(a) page: https://www.heart.org/en/health-topic... Literature: Pathophysiology and mechanisms van der Valk FM, et al. Oxidized phospholipids on lipoprotein(a) elicit arterial wall inflammation and an immune response. Circulation Research. 2016. PMC Genetics: Burgess S, et al. Association of LPA variants with risk of coronary disease and the implications for lipoprotein(a)-lowering therapies (Mendelian randomization). JAMA Cardiology. 2018. JAMA Network Lifestyle measures and supplements: Fogacci F, et al. Lifestyle and Lipoprotein(a) Levels: Does a Specific Intervention Work? (Review of weight loss, diet, exercise, supplements). Nutrients. 2024. Current medicines that indirectly help (and modestly lower Lp(a) in some cases) O’Donoghue ML, et al. Lipoprotein(a), PCSK9 inhibition, and cardiovascular risk (FOURIER analysis). Circulation. 2019. AHA Journals HPS2-THRIVE Collaborative Group. Effects of extended-release niacin with laropiprant in high-risk patients (clinical outcomes and adverse effects). NEJM. 2014. Apheresis: Schumann F, et al. Long-term lipoprotein apheresis reduces cardiovascular events in patients with elevated Lp(a) (outcomes study). Journal of Clinical Lipidology. 2024. Lipid Journal Future Lp(a) therapies O’Donoghue ML, et al. Small interfering RNA to reduce lipoprotein(a) in patients with cardiovascular disease (OCEAN(a)-DOSE). New England Journal of Medicine. 2022 Disclaimer: The contents of this video are for informational purposes only and are not intended to be medical advice, diagnosis, or treatment, nor to replace medical care. The information presented herein is accurate and conforms to the available scientific evidence to the best of the presenter/author's knowledge as of the time of posting. Always seek the advice of your physician or other qualified health provider with any questions regarding any medical condition. Never disregard professional medical advice or delay seeking it because of information contained in this channel/post.