HEART UK consensus statement on Lipoprotein(a): A call to action

Lipoprotein(a), Lp(a), is a modified atherogenic low-density lipoprotein particle that contains apolipoprotein(a). Its levels are highly heritable and variable in the population. This consensus statement by HEART UK is based on the evidence that Lp(a) is an independent cardiovascular disease (CVD) r...

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Published in:Atherosclerosis Vol. 291; pp. 62 - 70
Main Authors: Cegla, Jaimini, Neely, R.Dermot G., France, Michael, Ferns, Gordon, Byrne, Chris D., Halcox, Julian, Datta, Dev, Capps, Nigel, Shoulders, Carol, Qureshi, Nadeem, Rees, Alan, Main, Linda, Cramb, Robert, Viljoen, Adie, Payne, Jules, Soran, Handrean
Format: Journal Article
Language:English
Published: Ireland Elsevier B.V 01.12.2019
Subjects:
Biomarkers - blood
Blood Component Removal
Cardiovascular Diseases - epidemiology
Cardiovascular Diseases - prevention & control
Cardiovascular risk
Clinical Decision-Making
Consensus
Down-Regulation
Dyslipidemias - blood
Dyslipidemias - diagnosis
Dyslipidemias - epidemiology
Dyslipidemias - therapy
Humans
Hyperlipidemia
Hypolipidemic Agents - therapeutic use
Lipids
Lipoprotein(a)
Lipoprotein(a) - blood
Lp(a)
Myocardial infarction
Risk Assessment
Risk Factors
Stroke
Myocardial infarction
Lipoprotein(a)
Stroke
Hyperlipidemia
Cardiovascular risk
Lipids
Lp(a)
ISSN:0021-9150, 1879-1484, 1879-1484
Online Access:Get full text
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Summary:Lipoprotein(a), Lp(a), is a modified atherogenic low-density lipoprotein particle that contains apolipoprotein(a). Its levels are highly heritable and variable in the population. This consensus statement by HEART UK is based on the evidence that Lp(a) is an independent cardiovascular disease (CVD) risk factor, provides recommendations for its measurement in clinical practice and reviews current and emerging therapeutic strategies to reduce CVD risk. Ten statements summarise the most salient points for practitioners and patients with high Lp(a). HEART UK recommends that Lp(a) is measured in adults as follows: 1) those with a personal or family history of premature atherosclerotic CVD; 2) those with first-degree relatives who have Lp(a) levels >200 nmol/l; 3) patients with familial hypercholesterolemia; 4) patients with calcific aortic valve stenosis and 5) those with borderline (but <15%) 10-year risk of a cardiovascular event. The management of patients with raised Lp(a) levels should include: 1) reducing overall atherosclerotic risk; 2) controlling dyslipidemia with a desirable non-HDL-cholesterol level of <100 mg/dl (2.5 mmol/l) and 3) consideration of lipoprotein apheresis. [Display omitted] •The cardiovascular risk conferred by lipoprotein(a) is determined by the lipoprotein(a) serum concentration.•Serum lipoprotein(a) levels should be measured in five specific population groups.•Recommendations on the management of patients with raised lipoprotein(a) levels (>90 nmol/l) are discussed.
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ISSN:0021-9150
1879-1484
1879-1484
DOI:10.1016/j.atherosclerosis.2019.10.011