Lipoprotein (a) levels and outcomes in stable outpatients with symptomatic artery disease

Relation of High Lipoprotein (a) Concentrations to Platelet Reactivity in Individuals with and Without Coronary Artery Disease

“…The European Atherosclerosis Society Consensus Panel suggested 50 mg/dL of Lp( a ) as cutoff value for heightened risk for coronary events [ 7 ]. After 36 months mean follow-up period, stable outpatients with symptomatic CAD and Lp( a ) ≥ 50 mg/dL had a significantly higher risk of subsequent MI relative to those with Lp( a ) < 30 mg/dL [ 8 ]. A sub-analysis from the FOURIER study of more than 25,000 patients with established atherosclerotic cardiovascular disease treated with moderate- or high-intensity statin and randomized to evolocumab or placebo showed a 22% higher risk of major coronary events (coronary death, MI, or urgent revascularization) among patients in the fourth versus first quartile of Lp( a ) distribution [ 9 ].…”

Lipoprotein(a) apheresis in patients with peripheral arterial disease: rationale and clinical results

“…Although randomized controlled trials are missing and won't be possible to perform due to ethical reasons within the near future longitudinal observational studies strongly suggest that the reduction of lipoprotein(a) levels by lipoprotein apheresis significantly and clinical relevantly reduces the incidence of cardiovascular events [20][21][22][23]25]. There is increasing evidence from case-control studies, cross-sectional cohort studies and longitudinal prospective cohort studies that elevated lipoprotein(a) levels are a risk factor for the development of PAD and for a worse clinical outcome in PAD patients [11][12][13][14][15][16][17][18]. Furthermore, longitudinal observational studies indicated that lipoprotein apheresis also reduces the necessity for clinically driven revascularizations in patients with PAD [21,23,[25][26][27].…”

“…In patients with established symptomatic PAD elevated lipoprotein(a) levels also seem to be a risk factor for subsequent arterial events. Sanchez Monoz-Torreo et al [18] prospectively followed a Spanish cohort of 1503 outpatients with symptomatic PAD for a mean of 36 months. During that time patients suffered from 122 myocardial infarctions, 118 strokes, 58 lower limb amputations, and 85 deaths.…”

Hyperlipoproteinemia(a) as a dangerous genetically determined violation of lipid metabolism and a risk factor for atherothrombosis and cardiovascular diseases

“…Недавние ретроспективные исследования, проводимые в ФГБУ НМИЦ кардиологии, свидетельствуют о важной роли Лп(а) в развитии периферического атеросклероза [41]. Появились результаты крупных проспективных наблюдений, демонстрирующих многократное увеличение риска периферического атеросклероза у людей с гиперлипопротеидемией(а) [42,43]. В исследованиях KORA3 и 4 была выявлена тенденция более высокой концентрации Лп(а), так же как и меньшего количества повторов KIV 2 у больных с перемежающейся хромотой [44].…”

“…В исследованиях KORA3 и 4 была выявлена тенденция более высокой концентрации Лп(а), так же как и меньшего количества повторов KIV 2 у больных с перемежающейся хромотой [44]. При наблюдении за больными со стабильной ИБС уровень Лп(а) от 30 до 50 мг/дл ассоциировался с трехкратным увеличением риска ампутации нижних конечностей, тогда как у больных с Лп(а) >50 мг/дл -с двадцатикратным [43]. Также концентрация Лп(а) была достоверно выше у мужчин с перемежающейся хромотой по сравнению с пациентами, сравнимыми по полу, возрасту и частоте диабета [44].…”