Modestly โElevated 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 โคin individuals without other cardiovascularโฃ riskโ factors, โฃaccordingโค toโค aโฃ recent column by Dr. Roach publishedโ in [publication name unavailable from source]. While Lp(a) levels above 180 mg/dL are associated with considerably increased risk of heartโค attack and stroke, a โmoderate increase doesn’t automatically necessitate โtreatment.
Lp(a) isโฃ a โgenetically resolute riskโ factor for cardiovascular disease. โCurrently, โคthere are โno specific treatments directly targeting Lp(a) that โขhave demonstrably reduced heartโ disease risk. Statins, commonly โคused โto lower cholesterol, do not reduce Lp(a) and may even slightly increase levels, though they remain effective in reducing heart attackโค risk when combined with other riskโ factors.
Newer therapies show promise. PCSK-9 inhibitors,like evolocumab (Repatha),can reduce the risk of heart disease in people โwithโ high Lp(a) by approximately 25%. Inclisiran (Leqvio),a smallโ RNA molecule that lowers both Lp(a)โฃ and LDL cholesterol,isโข under examination,with early trialsโฃ yielding positive results,but its impact on heart attack and stroke โคrates is still being determined.
Dr. Roach emphasizes that Lp(a) is considered an additional โrisk โคfactor. Treatment decisions are โmade on a case-by-caseโ basis, factoring โฃin traditional risk factors likeโ LDL cholesterol,โ bloodโฃ pressure, smoking history, and diabetes. A moderate to high Lp(a) level โคmay prompt therapy for those at borderline risk, while a vrey high level, especially with a family history ofโข heart disease, might warrant โtreatment even in otherwise healthy individuals.
“In your case, I agree with your doctor that aโค modestly elevated Lp(a) level โขin a personโค withโฃ noโ other risk factors does not require โฃtreatment,” Dr. Roach concludes.