“Dr. Zhang, I always hear people say that lipoprotein (a) is a blood lipid index, but I also heard that there is no way to treat this index if it is too high. What should I do? Yes Is it a special medicine?” The patient, Uncle Liu, asked me that when he met him, which made me stunned for a moment.
I then patiently answered this question to Uncle Liu, and told him that there are 5 types of people in our country who should check this indicator, and the special medicine may be coming soon. Uncle Liu is very happy to hear this news. Today, I will share with you the knowledge that I answered to Uncle Liu. Please read this article patiently. #Cardiovascular health questions and answers#
Speaking of lipoprotein (a), Dr. Zhang has given you the relevant knowledge for many times in the past two years. In fact, to put it bluntly, lipoprotein (a), among many blood lipid indicators, after low-density lipoprotein, lipoprotein (a) has become an independent risk factor for cardiovascular and cerebrovascular diseases, especially the role of coronary heart disease. played an important role. So, in real life, who should pay special attention to checking lipoprotein(a)? Today, Dr. Zhang is here to explain this topic carefully to you.
1. What is lipoprotein (a)?
Lipoprotein (a), also known as lipid (a), is a special kind of lipoprotein particle, which is composed of apolipoprotein B100 on low-density lipoprotein particles with the help of disulfide Bond and apolipoprotein (a), its structure is similar to low-density lipoprotein, but different from low-density lipoprotein. It’s no exaggeration to compare them to “cousins”.
2. What are the hazards of elevated lipoprotein (a)?
Speaking of the dangers of elevated lipoprotein (a), many medical studies in recent years have suggested that lipoprotein (a) has pro-inflammatory and atherosclerotic effects. Abnormal elevation is an independent risk factor for cardiovascular and cerebrovascular diseases, especially coronary heart disease. And some studies have also found that there is a dose correlation between lipoprotein (a) and cardiovascular and cerebrovascular diseases. That is to say, the higher the lipoprotein (a), the greater the risk of cardiovascular and cerebrovascular diseases in the future. This is the greatest danger of lipoprotein (a).
Lipoprotein a is dangerous
3. How much is an increase in lipoprotein (a)?
The standard of elevated lipoprotein (a) is different at home and abroad. Our domestic standard is more than 300mg/l (0.3g/l, 30mg/dl, 75nmol/l) even if is raised. Since 2016, the relevant guidelines in Europe consider that more than 500mg/l (0.5g/l, 50mg/dl, 125nmol/l) is considered an increase. The higher the increase, the greater the risk of cardiovascular and cerebrovascular diseases in the future.
Here I would like to mention a digression. The measurement method with nmol/l as the unit of measurement is called the “molar concentration method”, which is considered to be a more accurate laboratory measurement method. The other three detection methods measured by mass concentration method can more accurately reflect the true level of lipoprotein (a).
Different dosage units have different reference values
4. Who should pay attention to checking lipoprotein(a)?
The following five categories of people should pay special attention to checking lipoprotein (a):
High and very high risk of cardiovascular and cerebrovascular diseases;
Patients with calcified aortic stenosis;
Patients with familial hypercholesterolemia;
Lipoprotein(a) of immediate family members in the family is higher than 900mg/l (200nmol/l);
A person in immediate family with premature cardiovascular disease.
In addition to the above 5 types of people, special attention should be paid to checking lipoprotein (a). In fact, for every normal healthy adult, it is necessary to pay attention to checking lipoprotein (a) at least once in life. indicators to understand their own lipoprotein (a) levels.
5. How to treat the elevated lipoprotein (a)?
Since the increase of lipoprotein (a) is so harmful, how should it be treated? Having said that, I have to say that lipoprotein (a) is a blood lipid indicator. According to the introduction of authoritative blood lipid textbooks, this blood lipid indicator is rarely affected by the external environment, and it cannot be reduced by improving lifestyle and statin lipid-lowering drugs. It mainly reflects the influence of genetics and genes on blood lipids. At this stage, there are no particularly good methods and drugs for reducing lipoprotein (a).
However, there is also good news, a new drug antisense oligonucleotide preparation that can lower lipoprotein (a), the English name is pelacarsen. The test has confirmed that it can significantly reduce lipoprotein (a) by 70-90%. It has entered the phase 3 clinical research stage and may meet you in the near future. Everyone, please wait for the good news.