Modestly Elevated lp(a) Doesn’t Warrant Treatment, Expert Says
New York, NY – A slightly elevated Lipoprotein(a) (lp(a)) level, such as 41 mg/dL, generally doesn’t require medical intervention in individuals without other cardiovascular risk factors, according to a recent column by Dr. Roach published in [publication name unavailable from source]. While Lp(a) levels above 180 mg/dL are associated with considerably increased risk of heart attack and stroke, a moderate increase doesn’t automatically necessitate treatment.
Lp(a) is a genetically resolute risk factor for cardiovascular disease. Currently, there are no specific treatments directly targeting Lp(a) that have demonstrably reduced heart disease risk. Statins, commonly used to lower cholesterol, do not reduce Lp(a) and may even slightly increase levels, though they remain effective in reducing heart attack risk when combined with other risk factors.
Newer therapies show promise. PCSK-9 inhibitors,like evolocumab (Repatha),can reduce the risk of heart disease in people with high Lp(a) by approximately 25%. Inclisiran (Leqvio),a small RNA molecule that lowers both Lp(a) and LDL cholesterol,is under examination,with early trials yielding positive results,but its impact on heart attack and stroke rates is still being determined.
Dr. Roach emphasizes that Lp(a) is considered an additional risk factor. Treatment decisions are made on a case-by-case basis, factoring in traditional risk factors like LDL cholesterol, blood pressure, smoking history, and diabetes. A moderate to high Lp(a) level may prompt therapy for those at borderline risk, while a vrey high level, especially with a family history of heart disease, might warrant treatment even in otherwise healthy individuals.
“In your case, I agree with your doctor that a modestly elevated Lp(a) level in a person with no other risk factors does not require treatment,” Dr. Roach concludes.
