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Therapy of Elevated Lipoprotein(a)

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Lipoprotein(a)

Part of the book series: Contemporary Cardiology ((CONCARD))

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Abstract

Lipoprotein(a) (Lp[a]) has consistently shown a causal association with cardiovascular outcomes in epidemiological studies, with a log-linear relationship between absolute Lp(a) level and cardiovascular risk. As a consequence, the largest cardiovascular benefit of Lp(a) lowering can be expected in patients with the highest baseline cardiovascular risk and highest Lp(a) levels. Currently, available therapeutic agents have only mild to moderate Lp(a) lowering effects. Since a meaningful cardiovascular benefit requires large absolute Lp(a) changes, it is unlikely that these small Lp(a) changes contribute significantly to a cardiovascular benefit. In the absence of potent Lp(a) lowering strategies, (intensification of) alternative cardiovascular risk lowering interventions are advised (LDL-C lowering, blood pressure lowering, healthy lifestyle) in an effort to minimize the Lp(a)-induced cardiovascular risk increase, taking into account the absolute global cardiovascular risk of the individual patient. Specific and potent RNA-targeted interventions are currently being evaluated in clinical trials, which will answer the pivotal question whether Lp(a) lowering reduces cardiovascular risk in these patients.

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Authors and Affiliations

  1. Department of Vascular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands

    S. Ibrahim & Erik S. G. Stroes

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  1. S. Ibrahim
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  2. Erik S. G. Stroes
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Correspondence to Erik S. G. Stroes .

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Editors and Affiliations

  1. Mater Hospital, University of Queensland, Brisbane, QLD, Australia

    Karam Kostner

  2. Medical University of Graz, Graz, Austria

    Gerhard M. Kostner

  3. Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Peter P. Toth

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Ibrahim, S., Stroes, E.S.G. (2023). Therapy of Elevated Lipoprotein(a). In: Kostner, K., Kostner, G.M., Toth, P.P. (eds) Lipoprotein(a). Contemporary Cardiology. Humana, Cham. https://doi.org/10.1007/978-3-031-24575-6_21

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  • DOI: https://doi.org/10.1007/978-3-031-24575-6_21

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  • Publisher Name: Humana, Cham

  • Print ISBN: 978-3-031-24574-9

  • Online ISBN: 978-3-031-24575-6

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