Lipoprotein(a): A Concealed Precursor of Increased Cardiovascular Risk? A Real-World Regional Lipid Clinic Experience

摘要

Objective. Lipoprotein(a) Lp(a) is an independent cardiovascular risk factor. We present real-life characteristics of patients with increased Lp(a) levels attending a University Lipid Clinic. Methods. We retrospectively studied patients attending the University of Ioannina Hospital Lipid Clinic with Lp(a) levels >= 30 mg/dL who were followed-up for a median of 22 months. Results. One hundred eight patients (median age 59 years, 49 females) were included with median Lp(a) levels 67 mg/dL (30-320). Of patients, 25.1 had established atherosclerotic cardiovascular disease (ASCVD): 11.1 and 5.6 positive personal history of myocardial infarction (MI) and stroke, respectively, 6.5 carotid artery disease and 1.9 lower extremities arterial disease (LEAD). In addition, 35.2 of participants had heterozygous familial hypercholesterolemia (heFH), 37.9 positive family history of premature ASCVD, 29.6 hypertension, 12.0 diabetes and 5.5 chronic kidney disease (CKD). Of patients, 67.6 were receiving statin therapy and 16.6 additional ezetimibe at baseline visit, and 83 and 35 were receiving statin treatment and additional ezetimibe, respectively, during follow-up. Low-density cholesterol (LDL-C) levels and LDL C-corrected for Lp(a) levels were significantly reduced in lipid-lowering therapy naive patients by 37 and 40 (p 0.05), respectively, during follow-up. Lp(a) levels increased by 9 (p <0.05). Conclusion. Our data confirm the high prevalence of established ASCVD, hFH and positive familial history of premature ASCVD in patients with elevated Lp(a) levels. Lp(a) levels slightly increased during follow-up. (C) 2020 IMSS. Published by Elsevier Inc.