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Lipoprotein (a), also known as Lp(a), is a type of lipoprotein that is structurally similar to low-density lipoprotein (LDL). It consists of an LDL-like particle with a specific protein called apolipoprotein (a) attached to it. Elevated levels of Lp(a) in the blood are significantly involved in the development of cardiovascular diseases, particularly atherosclerosis and aortic stenosis, by contributing to inflammation, oxidative stress, and calcification. Numerous epidemiological studies confirm the strong association between high Lp(a) levels and an increased risk of cardiovascular events such as myocardial infarction and stroke, highlighting the importance of including Lp(a) screening in comprehensive cardiovascular health evaluations. The positive correlation between high Lp(a) levels and increased cardiovascular risk underscores the need for developing appropriate and effective treatments to lower Lp(a) levels in patients. [ABSTRACT FROM AUTHOR]

Hypertension is the most important risk factor for cardiovascular disease and the main cause of death worldwide. Some studies have reported a positive association between microalbuminuria and lipoprotein (a) with cardiovascular disease in hypertensive patients. Hence, the objective of this paper was to assess albuminuria and serum levels of Lipoprotein (a) (Lp [a]) and their correlation in hypertensive patients in a Government hospital in Warri, Delta State, Nigeria using appropriate standard techniques. Data collected showed that Thirty (15.0%) vs. 0 (0.0%) had microalbuminuria in the hypertensive and control groups respectively. The difference in the two groups was statistically significant (P-value =0.046). The mean urine albumin-creatinine ratio (UACR) were 1.02 ± 1.42 vs. 0.28 ± 0.16 mg/mmol in the hypertensive and control groups respectively. The difference in the two groups was statistically significant (<0.001). One hundred and fifteen (57.5%) vs. 18 (18.0%) had elevated Lp (a) in hypertensive and control groups respectively. The difference in the two groups was statistically significant (P-value <0.001). The mean Lp (a) were 32.77 ± 16.61 vs. 16.88 ± 13.85 mg/dl in the hypertensive and control groups respectively. The difference in the two groups was statistically significant (<0.001). There was a significant weak negative correlation between UACR and Lp (a) in the hypertensive group (Pearson's Correlation = -0.214, P-value = 0.019). The serum levels of Lp (a) and UACR were significantly higher in the hypertensives than in the controls. There was a significant weak negative correlation between UACR and Lp (a) in the hypertensive group. Thus, routine screening for serum Lp (a) will enhance the assessment of hypertensive patients for risk of cardiovascular disease. [ABSTRACT FROM AUTHOR]

Background: Recent studies have suggested that adverse events associated with lipoprotein(a) [Lp(a)] might be modified by low‐density lipoprotein cholesterol (LDL‐C) or high‐sensitivity C‐reactive protein (hs‐CRP) levels, but whether LDL‐C and hs‐CRP jointly mediate the outcome of Lp(a) remains unknown in patients with coronary artery disease. Methods and Results: A prospective study was conducted, enrolling consecutive 10 724 patients with percutaneous coronary intervention (PCI) in 2013. The endpoint event was all‐cause death. A total of 10 000 patients with complete baseline data were finally included. During a median follow‐up of 5.1 years, Lp(a) ≥ 30 mg/dL was an independent risk factor of all‐cause death in the overall population, LDL‐C ≥ 70 mg/dL, and hs‐CRP ≥ 2 mg/L population, respectively. According to concurrent LDL‐C (70 mg/dL) and hs‐CRP (2 mg/L) levels, further analysis revealed that when LDL‐C < 70 mg/dL regardless of hs‐CRP levels, Lp(a) ≥ 30 mg/dL was not an independent predictor of all‐cause death. However, when LDL‐C ≥ 70 mg/dL, Lp(a) ≥ 30 mg/dL was independently associated with a higher risk of all‐cause death in hs‐CRP ≥ 2 mg/L (HR: 1.488, 95% CI: 1.059‒2.092), but not in hs‐CRP < 2 mg/L (HR: 1.303, 95% CI: 0.914‒1.856). Conclusion: Among PCI patients, Lp(a)‐associated outcome was jointly affected by LDL‐C and hs‐CRP. As long as LDL‐C is well controlled, the adverse effects of increased Lp(a) on cardiovascular risk seem to be weakened, and only when LDL‐C and hs‐CRP increase at the same time, elevated Lp(a) is associated with poorer long‐term outcome. [ABSTRACT FROM AUTHOR]

Background: Elevated lipoprotein (Lp(a)) levels are associated with increased risk of atherosclerotic processes and cardiovascular events in adults. The amount of Lp(a) is mainly genetically determined. Therefore, it is important to identify individuals with elevated Lp(a) as early as possible, particularly if other cardiovascular risk factors are present. The purpose of the study was to investigate whether, in a population of children and adolescents already followed for the presence of one or more cardiovascular risk factors (elevated blood pressure (BP), and/or excess body weight, and/or dyslipidemia), the measurement of Lp(a) can be useful for better stratifying their risk profile. Methods: In a sample of 195 children and adolescents, height, body weight, waist circumference and systolic (SBP) and diastolic (DBP) BP were measured. Body Mass Index (BMI) and SBP and DBP z-scores were calculated. Plasma Lp(a), total cholesterol, high-density lipoprotein (HDL), triglycerides, glucose, insulin, uric acid and creatinine were assessed. Low-density lipoprotein (LDL) cholesterol was calculated with the Friedewald formula. High Lp(a) was defined as ≥ 75 nmol/L and high LDL cholesterol as ≥ 3.37 mmol/L. Results: Our sample of children and adolescents (54.4% males, mean age 11.5 years) had median LDL cholesterol and Lp(a) values equal to 2.54 (interquartile range, IQR: 2.07–3.06) mmol/L and 22 (IQR: 7.8–68.6) nmol/L respectively. 13.8% of children had LDL cholesterol ≥ 3.37 mmol/L and 22.6 Lp(a) values ≥ 75 nmol/L. Lp(a) values were higher in children of normal weight than in those with excess weight (p = 0.007), but the difference disappeared if normal weight children referred for dyslipidemia only were excluded from the analysis (p = 0.210). 69.4% of children had normal Lp(a) and LDL cholesterol values and only 6.2% showed both elevated Lp(a) and LDL cholesterol levels. However, 16.6% of the sample, despite having normal LDL cholesterol, had elevated Lp(a) values. Multivariable analyses showed a significant association of LDL cholesterol both with Lp(a) values, and with the presence of elevated Lp(a) levels. For each mmol/L increase in LDL cholesterol the risk of having an elevated Lp(a) value increased by 73%. There was an inverse correlation between BMI z-score and Lp(a). Neither BP z-scores, nor other biochemical parameters were associated with Lp(a). Conclusions: In our population more than one out of five children had elevated Lp(a) values, and in about 17% of children elevated Lp(a) values were present in the absence of increased LDL cholesterol. Our results suggest that Lp(a) measurement can be useful to better define the cardiovascular risk profile in children and adolescents already followed for the presence of other cardiovascular risk factors such as elevated BP, excess body weight and high LDL cholesterol. [ABSTRACT FROM AUTHOR]

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Aim. To establish the frequency of achieving target of blood pressure (BP) levels and lipid spectrum parameters (LS) in patients with arterial hypertension (AH) and multifocal atherosclerotic lesion (MFAL) with normal and elevated levels of lipoprotein (a) (Lp(a)) in real clinical practice.Material and methods. The study included 110 patients with AH and MFAL, median age was 59.0 (51.0; 64.3) years. Depending on the level of Lp(a), all patients were divided into 2 groups: group 1 — 72 patients (65.5%), Lp(a) level was ≤50 mg/dl (13.2 (3.7; 21.1)), group 2 — 38 patients (34.5%) Lp(a) level was >50 mg/dl (89.5 (62.5; 110.0)). The diagnosis of MFAL included damage to two or more arterial basins according to carotid artery, abdominal aorta and lower extremities arteries duplex scan. Patients of both groups received antihypertensive, lipid-lowering, and antiplatelet therapy.Results. Patients in groups 1 and 2 showed similar blood pressure levels and frequency of antihypertensive therapy use. In both groups, the majority of patients were on a free combination of antihypertensive drugs, only a third of patients used a fixed combination. In most cases, patients of both groups did not reach the target blood pressure levels (63.9% — group 1, 55.3% — group 2), despite the fact that the average blood pressure figures were relatively low (132;83 mmHg in each group). Drug control was also unsatisfactory in both groups, regardless of the level of Lp(a). However, all drug indicators were significantly worse in group 2, despite comparable lipid-lowering therapy, which more often included statin monotherapy. Combination therapy with lipid-lowering drugs was used in patients of groups 1 and 2 only in 20.8% and 10.5%, respectively. Parameters of low-grade inflammation high-sensitivity C-reactive protein and interleukin-6 did not differ between the groups and did not exceed the reference values.Conclusion. An increased level of Lp(a) may be accompanied by drug disorders and increased BP in patients with MFAL. Due to the lack of effective Lp(a) reducing therapy, the prevention of cardiovascular events in such patients should focus on BP and lipid spectrum correction. The use of fixed combinations, including antihypertensive and lipid-lowering drugs, can lead to improved adherence to therapy, increased BP and LS control.

Abstract Background Elevated lipoprotein (Lp(a)) levels are associated with increased risk of atherosclerotic processes and cardiovascular events in adults. The amount of Lp(a) is mainly genetically determined. Therefore, it is important to identify individuals with elevated Lp(a) as early as possible, particularly if other cardiovascular risk factors are present. The purpose of the study was to investigate whether, in a population of children and adolescents already followed for the presence of one or more cardiovascular risk factors (elevated blood pressure (BP), and/or excess body weight, and/or dyslipidemia), the measurement of Lp(a) can be useful for better stratifying their risk profile. Methods In a sample of 195 children and adolescents, height, body weight, waist circumference and systolic (SBP) and diastolic (DBP) BP were measured. Body Mass Index (BMI) and SBP and DBP z-scores were calculated. Plasma Lp(a), total cholesterol, high-density lipoprotein (HDL), triglycerides, glucose, insulin, uric acid and creatinine were assessed. Low-density lipoprotein (LDL) cholesterol was calculated with the Friedewald formula. High Lp(a) was defined as ≥ 75 nmol/L and high LDL cholesterol as ≥ 3.37 mmol/L. Results Our sample of children and adolescents (54.4% males, mean age 11.5 years) had median LDL cholesterol and Lp(a) values equal to 2.54 (interquartile range, IQR: 2.07–3.06) mmol/L and 22 (IQR: 7.8–68.6) nmol/L respectively. 13.8% of children had LDL cholesterol ≥ 3.37 mmol/L and 22.6 Lp(a) values ≥ 75 nmol/L. Lp(a) values were higher in children of normal weight than in those with excess weight (p = 0.007), but the difference disappeared if normal weight children referred for dyslipidemia only were excluded from the analysis (p = 0.210). 69.4% of children had normal Lp(a) and LDL cholesterol values and only 6.2% showed both elevated Lp(a) and LDL cholesterol levels. However, 16.6% of the sample, despite having normal LDL cholesterol, had elevated Lp(a) values. Multivariable analyses showed a significant association of LDL cholesterol both with Lp(a) values, and with the presence of elevated Lp(a) levels. For each mmol/L increase in LDL cholesterol the risk of having an elevated Lp(a) value increased by 73%. There was an inverse correlation between BMI z-score and Lp(a). Neither BP z-scores, nor other biochemical parameters were associated with Lp(a). Conclusions In our population more than one out of five children had elevated Lp(a) values, and in about 17% of children elevated Lp(a) values were present in the absence of increased LDL cholesterol. Our results suggest that Lp(a) measurement can be useful to better define the cardiovascular risk profile in children and adolescents already followed for the presence of other cardiovascular risk factors such as elevated BP, excess body weight and high LDL cholesterol.

Lipoprotein (a) [Lp (a) ] is significantly related to atherosclerotic cardiovascular disease (ASCVD), but it is unclear whether clinical agents that lower Lp (a) can reduce the risk of ASCVD. Here, we systematically reviewed the structure, function, genetic characteristics and detection status of Lp (a), discussed the relationship of Lp (a) with ASCVD, aortic valve stenosis and other cardiovascular diseases, and summarized new advance of Lp (a) -lowering therapies. The structural composition of Lp (a) indicates that Lp (a) may promote atherosclerosis, inhibit fibrinolytic reaction and promote inflammation. Multiple evidence from genetic studies and epidemiological studies supports that Lp (a) is significantly associated with an increased risk of ASCVD and major adverse cardiovascular events. In addition, Lp (a) is also associated with other cardiovascular diseases such as aortic valve stenosis. At present, several emerging drugs that lower Lp (a) are in clinical trials and may further reduce residual cardiovascular risk. This paper hopes to offer new thought for the study of Lp (a), and provide a basis for the monitoring and management of blood lipids.

Introduction Lipoprotein(a) [Lp(a)] is an independent risk factor for atherosclerotic cardiovascular disease (ASCVD). Increased Lp(a) concentration > 30 mg/dl (75 nmol/l) and especially >50 mg/dl (125 nmol/l) may cause faster atherosclerosis, being an important and underdiagnosed residual cardiovascular risk factor. Thus, there is a need to characterize further the clinical phenotypes in patients at risk for ASCVD with high Lp(a) levels now and during follow-up, while also looking for the possible impact of geographical differences. Material and methods The Zabrze Lipoprotein(a) Registry (Zabrze-Lip(a)R) was founded on the basis of data from 2,001 consecutive patients with very high cardiovascular risk treated in a tertiary hospital. The registry patients will be followed for at least 5 years with the possibility of extending this period as an open label study. All-cause and cause-specific mortality, hospitalizations, and cardiovascular events, such as myocardial infarction (MI) and stroke, will be assessed. Results The mean age of patients was 66.4 years (females 37.1%). The median Lp(a) concentration in the entire population was 6.6 mg/dl (16.5 nmol/l) (mean: 14.3 ±19.4 mg/dl). 540 (27%) patients had elevated Lp(a) levels above 30 mg/dl (75 nmol/l); they were significantly older (68.8 vs. 66.3 years; p = 0.04), had significantly lower hemoglobin and hematocrit, and higher platelet count and levels of NT-proBNP and C-reactive protein. The prevalence of elevated Lp(a) > 30 mg/dl (75 nmol/l) concentrations was very high in patients with a chronic coronary syndrome (CCS) (52.2% (282/540) vs. 41.5% (607/1461); p 30 mg/dl (75 nmol/l) were only lower Hb values (OR = 0.925; 95% CI: 0.874–0.978; p = 0.006) and higher platelet count (1.002; 95%CI: 1.000–1.003; p < 0.02). Conclusions In Poland, the largest representative of Central and Eastern European countries, 27% of patients at very high cardiovascular risk with established ASCVD experience additional risk related to an elevated Lp(a) level, with every second patient having CCS. Interestingly, only two factors were significantly related to elevated Lp(a) levels: lower Hb values and higher platelet count. However, the clinical relevance of these results needs confirmation.

Abstract Background The present study aimed to evaluate the effects of 24 weeks of moderate aerobic exercise on lipids and lipoprotein levels; Lipo (a) markers, and their association with cognitive performance in healthy older adults. Methods A total of 150 healthy subjects (100 males and 50 females; age range: 65–95 years) were recruited for this study. Based on the LOTCA test score, subjects were classified into two groups: the control group (n = 50) and the cognitive impairment group (n = 100). Cognitive functioning, leisure-time physical activity (LTPA), lipid profile, total cholesterol, TG, HDL-c, LDL-C, and lipo(a) were assessed at baseline and post-24-week aerobic exercise interventions using LOTCA battery, pre-validated Global Physical Activity Questionnaire (GPAQ) version II, colorimetric, and immunoassay techniques, respectively. Results Significant improvements in cognitive function and modulation in lipid profile and lipoprotein (a) markers were reported in all older subjects following 24 weeks of moderate exercise. LOTCA-7-sets scores significantly correlated with physical activity status and the regulation of lipids and Lipo (a) markers. Physically active persons showed higher cognitive performance along with a reduction in the levels of T-Cholest., TG, LDL-C, Lipo (a), and an increase in the levels of HDL-C and aerobic fitness VO2max compared with sedentary participants. Cognitive performance correlated positively with increased aerobic fitness, HDL-C, and negatively with T-Cholest., TG, LDL-C, and Lipo (a). However, a significant increase in the improvement of motor praxis, vasomotor organization, thinking operations, attention, and concentration were reported among older adults. Conclusions The study findings revealed that supervised moderate aerobic training for 24 weeks significantly enhances cognitive functions via mitigating older adults’ lipid profiles and lipoprotein (a). Cognitive performance is positively correlated with aerobic fitness and HDL-C level and negatively with T-Cholest., TH, LDL-C, and Lipo (a).

Abstract Background Serum lipoprotein(a) [Lp(a)] is an independent risk factor for atherosclerotic cardiovascular disease (ASCVD) in the general population, its association with ASCVD incidence in Chinese maintenance hemodialysis (MHD) patients remains unclear. We aimed to evaluate the relationship between Lp(a) levels and ASCVD incidence among MHD patients in Beijing, China. Methods This retrospective, observational cohort study included MHD patients at Beijing Tongren Hospital from January 1, 2013 to December 1, 2020, and followed until December 1,2023. The primary outcome was ASCVD occurrence. Kaplan-Meier survival analysis was used to evaluate ASCVD-free survival in MHD patients, with stratification based on Lp(a) levels. Cox regression analyses were conducted to assess the association between Lp(a) levels and the occurrence of ASCVD. Results A total of 265 patients were enrolled in the study. The median follow-up period were 71 months.78 (29.4%) participants experienced ASCVD events, and 118 (47%) patients died, with 58 (49.1%) deaths attributed to ASCVD. Spearman rank correlation analyses revealed positive correlations between serum Lp(a) levels and LDL-c levels, and negative correlations with hemoglobin, triglyceride, serum iron, serum creatinine, and albumin levels. Multivariate Cox regression analysis showed that Lp(a) levels ≥ 30 mg/L, increased age, decreased serum albumin levels, and a history of diabetes mellitus were significantly associated with ASCVD incidence. Conclusions This study demonstrated an independent and positive association between serum Lp(a) levels and the risk of ASCVD in MHD patients, suggesting that serum Lp(a) could potentially serve as a clinical biomarker for estimating ASCVD risk in this population.

Abstract Background Diabetes mellitus (DM) and Lp(a) are well-established predictors of coronary artery disease (CAD) outcomes. However, their combined association remains poorly understood. Objective To investigate the relationship between elevated Lp(a) and DM with CAD outcomes. Methods Retrospective analysis of the MGB Lp(a) Registry involving patients ≥ 18 years who underwent Lp(a) measurements between 2000 and 2019. Exclusion criteria were severe kidney dysfunction, malignant neoplasms, and prior atherosclerotic cardiovascular disease (ASCVD). The primary outcome was a combination of cardiovascular death or myocardial infarction (MI). Elevated Lp(a) was defined as > 90th percentile (≥ 216 nmol/L). Results Among 6,238 patients who met the eligibility criteria, the median age was 54, 45% were women, and 12% had DM. Patients with DM were older, more frequently male, and had a higher prevalence of additional cardiovascular risk factors. Over a median follow-up of 12.9 years, patients with either DM or elevated Lp(a) experienced higher rates of the primary outcome. Notably, those with elevated Lp(a) had a higher incidence of the primary outcome regardless of their DM status. The annual event rates were as follows: No-DM and Lp(a) 90th% − 1.3%; DM and Lp(a) 90th% − 4.7% (p

Objective To analyze the factors related to the severity of coronary artery disease (CAD) in type 2 diabetes mellitus (T2DM) patients, with the aim of providing a reference for the risk assessment of them. Methods Clinical data of 322 T2DM patients combined with CAD admitted to Jinan City People's Hospital from January 2019 to May 2023 were retrospectively analyzed. They were divided into the mild group (Gensini score≤54, n=177) and the moderate to severe group (Gensini score＞54, n=145) based on the Gensini score. The clinical data of age, gender, and blood indexes between the two groups were compared. Least absolute shrinkage and selection operator (LASSO) and logistic regression analysis were used to screen for factors correlated with the severity of CAD in T2DM patients. The prediction model was established, the model calibration curve and the receiver operating characteristic curve (ROC) were drawn, and the area under the curve (AUC) was calculated to evaluate its accuracy. Results Age, total cholesterol, fasting blood glucose, remnant cholesterol and lipoprotein (a) levels were higher in the moderate to severe CAD in the mild group (P＜0.05).For patients with moderate to severe coronary artery lesions in T2DM, the multivariate logistic regression analysis showed that age, residual cholesterol and serum lipoprotein (a) levels were independent risk factors (P＜0.05). LASSO regression showed age (Z=3.251, P=0.001), residual cholesterol (Z=2.565, P=0.010) and serum lipoprotein (a) levels (Z=7.989, P＜0.001) were independent predictor of T2MD patients with moderate to serve CAD, 〖JP+1〗and the column chart prediction model constructed from the above factors had good accuracy (AUC=0.826). Conclusion Age, remnant cholesterol and lipoprotein (a) levels can effectively predict the severity of CAD in T2DM patients, and have good accuracy.

Calcific aortic valve disease (CAVD) is a common acquired valvular heart disease that may cause heart failure and sudden cardiac death. However, there is currently no effective interventions to prevent or slow down the CAVD. Recent studies have found that lipoprotein a [Lp(a)] is closely related to the occurrence and development of CAVD. This article reviews the mechanism, clinical research, and potential therapeutic targets of Lp(a) and CAVD, in order to improve the understanding of the clinical prevention and treatment of Lp(a) and CAVD. [ABSTRACT FROM AUTHOR]

Background: Elevated lipoprotein (a) [Lp(a)] concentrations are linked mainly to genetic factors. The relationship between Lp(a) and other lipid disorders or cardiovascular (CV) risk factors has been less investigated. The aim of this study was to assess the occurrence of lipid disorders and other CV risk factors according to Lp(a) concentrations. Methods: A cross-sectional analysis of 200 primary-care patients who had not been diagnosed with CV disease was conducted. The following risk factors were assessed: older age, history of hypertension, diabetes mellitus or dyslipidemia, smoking, lack of physical activity, body mass index (BMI), and waist circumference. The following lipid parameters were measured: total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), and small, dense LDL (sdLDL-C). Patients were divided into two groups based on their Lp(a) concentrations: <30 mg/dL and ≥30 mg/dL. Results: In 70% of patients, the Lp(a) concentration was <30 mg/dL. The concentrations of lipid parameters did not differ between the groups. The rate of patients with sdLDL-C >1.0 mmol/L was higher in the low-Lp(a) group (10.0 vs. 1.7%, p = 0.04), with no significant differences regarding the other analyzed lipid disorders (p > 0.05). Both in the low- and high-Lp(a) group, most patients had two other abnormal lipid factors (45.0% and 60.0%, respectively). The distribution of impaired lipid parameters (p = 0.41) and other CV risk factors (p = 0.16) was similar in both groups. There was a lower rate of patients >60 years old (15.0% vs. 32.9%, p = 0.01) and with a BMI ≥ 25 kg/m2 (46.7% vs. 63.6%, p = 0.026) in the high-Lp(a) group, and previously diagnosed hyperlipidemia was more prevalent in this group (65.0% vs. 47.1%, p = 0.02). The occurrence of other cardiovascular risk factors did not differ significantly between the Lp(a) groups (p > 0.05). In the high-Lp(a) group, the highest proportion (25.0%) had two CV risk factors, and in the low-Lp(a) group, 31.4% had four CV risk factors. Conclusions: An elevated Lp(a) concentration is not related to the number of conventional CV risk factors or other impairment major lipid parameters. [ABSTRACT FROM AUTHOR]

Background: The present study aimed to evaluate the effects of 24 weeks of moderate aerobic exercise on lipids and lipoprotein levels; Lipo (a) markers, and their association with cognitive performance in healthy older adults. Methods: A total of 150 healthy subjects (100 males and 50 females; age range: 65–95 years) were recruited for this study. Based on the LOTCA test score, subjects were classified into two groups: the control group (n = 50) and the cognitive impairment group (n = 100). Cognitive functioning, leisure-time physical activity (LTPA), lipid profile, total cholesterol, TG, HDL-c, LDL-C, and lipo(a) were assessed at baseline and post-24-week aerobic exercise interventions using LOTCA battery, pre-validated Global Physical Activity Questionnaire (GPAQ) version II, colorimetric, and immunoassay techniques, respectively. Results: Significant improvements in cognitive function and modulation in lipid profile and lipoprotein (a) markers were reported in all older subjects following 24 weeks of moderate exercise. LOTCA-7-sets scores significantly correlated with physical activity status and the regulation of lipids and Lipo (a) markers. Physically active persons showed higher cognitive performance along with a reduction in the levels of T-Cholest., TG, LDL-C, Lipo (a), and an increase in the levels of HDL-C and aerobic fitness VO2max compared with sedentary participants. Cognitive performance correlated positively with increased aerobic fitness, HDL-C, and negatively with T-Cholest., TG, LDL-C, and Lipo (a). However, a significant increase in the improvement of motor praxis, vasomotor organization, thinking operations, attention, and concentration were reported among older adults. Conclusions: The study findings revealed that supervised moderate aerobic training for 24 weeks significantly enhances cognitive functions via mitigating older adults' lipid profiles and lipoprotein (a). Cognitive performance is positively correlated with aerobic fitness and HDL-C level and negatively with T-Cholest., TH, LDL-C, and Lipo (a). [ABSTRACT FROM AUTHOR]

Introduction: Lipoprotein(a) [Lp(a)] is an independent risk factor for atherosclerotic cardiovascular disease (ASCVD). Increased Lp(a) concentration > 30 mg/dl (75 nmol/l) and especially >50 mg/dl (125 nmol/l) may cause faster atherosclerosis, being an important and underdiagnosed residual cardiovascular risk factor. Thus, there is a need to characterize further the clinical phenotypes in patients at risk for ASCVD with high Lp(a) levels now and during follow-up, while also looking for the possible impact of geographical differences. Material and methods: The Zabrze Lipoprotein(a) Registry (Zabrze-Lip(a)R) was founded on the basis of data from 2,001 consecutive patients with very high cardiovascular risk treated in a tertiary hospital. The registry patients will be followed for at least 5 years with the possibility of extending this period as an open label study. All-cause and cause-specific mortality, hospitalizations, and cardiovascular events, such as myocardial infarction (MI) and stroke, will be assessed. Results: The mean age of patients was 66.4 years (females 37.1%). The median Lp(a) concentration in the entire population was 6.6 mg/dl (16.5 nmol/l) (mean: 14.3 ±19.4 mg/dl). 540 (27%) patients had elevated Lp(a) levels above 30 mg/dl (75 nmol/l); they were significantly older (68.8 vs. 66.3 years; p = 0.04), had significantly lower hemoglobin and hematocrit, and higher platelet count and levels of NT-proBNP and C-reactive protein. The prevalence of elevated Lp(a) > 30 mg/dl (75 nmol/l) concentrations was very high in patients with a chronic coronary syndrome (CCS) (52.2% (282/540) vs. 41.5% (607/1461); p < 0.001), in patients undergoing PCI during hospitalization (23.9 vs. 19%; p = 0.01), and in patients with previous MI (20.6% vs. 14.9%; p = 0.0022). In the multivariable analysis, the independent predictors of elevated Lp(a) > 30 mg/dl (75 nmol/l) were only lower Hb values (OR = 0.925; 95% CI: 0.874-0.978; p = 0.006) and higher platelet count (1.002; 95%CI: 1.000-1.003; p < 0.02). Conclusions: In Poland, the largest representative of Central and Eastern European countries, 27% of patients at very high cardiovascular risk with established ASCVD experience additional risk related to an elevated Lp(a) level, with every second patient having CCS. Interestingly, only two factors Krzysztof Dyrbuś, Zofia Mędrala, Karolina Konsek, Alicja Nowowiejska-Wiewióra, Przemysław Trzeciak, Michał Skrzypek, Daniel Cieśla, Maciej Banach, Mariusz Gąsior were significantly related to elevated Lp(a) levels: lower Hb values and higher platelet count. However, the clinical relevance of these results needs confirmation. [ABSTRACT FROM AUTHOR]

Background: Atherosclerotic cardiovascular disorders, such as stroke, have been linked to the formation of lipoprotein (A) [Lp(a)], a genetically determined lipoprotein variation. Elevated Lp(a) is a crucial component in the pathogenesis of stroke since it is linked to an increased risk of ischaemic stroke. The study assessed Lp(a) levels in acute stroke patients. Methods: 49 stroke individuals and 49 age- and sex-matched healthy participants participated in the study. Lipid profiles, serum Lp(a) levels, and several biochemical markers were assessed. SPSS software was utilised for statistical analyses, with a significance threshold of p < 0.05. Results: The mean age of stroke patients was 61 years, with 46.94% being female. Elevated Lp(a) levels were observed in stroke patients (57.01 ± 15.99 mg/dL) compared to controls (17.75 ± 11.61 mg/dL), with a significant difference (p < 0.0001). Elevated Lp(a) levels were found in 85.71% of cases and in only one control subject. Females had higher mean Lp(a) levels (61.76 ± 15.93 mg/dL) than males (52.26 ± 12.05 mg/dL) among stroke patients (p < 0.05). Conclusion: Raised Lp(a) levels are significantly correlated with acute stroke in this cohort, particularly among females. Dyslipidemia is also prevalent among stroke patients. These findings highlight the importance of Lp(a) as an independent risk factor for stroke. Recommendations: Routine screening for Lp(a) levels in individuals at risk of cardiovascular diseases, especially those with a family history or existing comorbidities, is recommended. Further research into targeted therapies to lower Lp(a) levels is essential. [ABSTRACT FROM AUTHOR]

Background: Serum lipoprotein(a) [Lp(a)] is an independent risk factor for atherosclerotic cardiovascular disease (ASCVD) in the general population, its association with ASCVD incidence in Chinese maintenance hemodialysis (MHD) patients remains unclear. We aimed to evaluate the relationship between Lp(a) levels and ASCVD incidence among MHD patients in Beijing, China. Methods: This retrospective, observational cohort study included MHD patients at Beijing Tongren Hospital from January 1, 2013 to December 1, 2020, and followed until December 1,2023. The primary outcome was ASCVD occurrence. Kaplan-Meier survival analysis was used to evaluate ASCVD-free survival in MHD patients, with stratification based on Lp(a) levels. Cox regression analyses were conducted to assess the association between Lp(a) levels and the occurrence of ASCVD. Results: A total of 265 patients were enrolled in the study. The median follow-up period were 71 months.78 (29.4%) participants experienced ASCVD events, and 118 (47%) patients died, with 58 (49.1%) deaths attributed to ASCVD. Spearman rank correlation analyses revealed positive correlations between serum Lp(a) levels and LDL-c levels, and negative correlations with hemoglobin, triglyceride, serum iron, serum creatinine, and albumin levels. Multivariate Cox regression analysis showed that Lp(a) levels ≥ 30 mg/L, increased age, decreased serum albumin levels, and a history of diabetes mellitus were significantly associated with ASCVD incidence. Conclusions: This study demonstrated an independent and positive association between serum Lp(a) levels and the risk of ASCVD in MHD patients, suggesting that serum Lp(a) could potentially serve as a clinical biomarker for estimating ASCVD risk in this population. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to examine the relationship between lipoprotein (a) (Lp[a]) and other blood lipid indexes and carotid artery atherosclerosis in patients with acute ischemic stroke (AIS). Methods: A total of 2,018 patients were selected from the hospital “acute stroke intervention and secondary prevention registration database” by identifying blood fat indexes (cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and Lp[a]). Based on the results of carotid artery ultrasound examinations, the patients were divided into a “no plaque” group, comprising 400 patients, a “plaque and no stenosis” group, comprising 1,122 patients and a “carotid stenosis” group, comprising 496 patients. The relationship between Lp(a) and blood lipid indexes and carotid artery atherosclerosis was then investigated using multi-factor logistics regression analysis. Results: There were 400 patients (19.8%) with no carotid plaque, 1,122 patients (55.6%) with plaque and no carotid stenosis and 496 patients (24.6%) with carotid stenosis. As the degree of carotid artery atherosclerosis increased, the Lp(a) level gradually increased; Lp(a) and cholesterol were identified as independent risk factors for carotid atherosclerosis. Conclusion: Lipoprotein (a) and cholesterol are independent risk factors for patients with AIS with carotid atherosclerosis, and their levels increase with the degree of carotid artery atherosclerosis; therefore, attention should focus on levels of cholesterol and Lp(a) in acute stroke patients to control atherosclerosis effectively. [ABSTRACT FROM AUTHOR]

Background: Biliary tract cancers have garnered significant attention due to their highly malignant nature. The relationship between abnormal lipid metabolism and tumor occurrence and development is a research hotspot. However, its correlation with biliary tract cancers is unclear. Methods: We enrolled 78 patients with biliary tract cancers and obtained data on clinical characteristics, pathological findings, and preoperative blood lipid indices, including total cholesterol (TC), high‐density lipoprotein cholesterol (HDL‐C), low‐density lipoprotein cholesterol (LDL‐C), triglycerides (TG), and lipoprotein (a) [Lp(a)]. Receiver operating characteristic (ROC) curves were used to determine the optimal predictive cutoff values of lipid indicators among the participants. Independent risk factors were determined using Cox regression, and survival was predicted using the Kaplan–Meier method. Statistical analyses were performed using SPSS software. Results: Univariate Cox regression analysis revealed that the body mass index (BMI), tumor location, surgical margin, N stage, and abnormally increased LDL‐C, TG, and Lp(a) levels were significantly associated with poor prognosis of biliary tract cancers (p < 0.05). Multifactor Cox regression demonstrated that only N stage (HR = 3.393, p < 0.001) and abnormally increased Lp(a) levels (HR = 2.814, p = 0.004) were significantly associated with shorter survival. N stage and Lp(a) were identified as independent prognostic risk factors for patients with biliary tract cancers. Conclusion: This study presents Lp(a) as a novel biochemical marker that can guide clinical treatment strategies for patients with biliary tract cancers. More effective treatment options and intensive postoperative testing should be considered to prolong the survival of these patients with preoperative abnormal lipid metabolism. [ABSTRACT FROM AUTHOR]

Background Lipoprotein (a) is an independent risk factor for atherosclerotic cardiovascular disease. However, lipoprotein (a) testing remains variable and it is unclear what factors influence testing and if testing changes clinical management. Methods and Results A retrospective study using electronic medical record data from 5 health systems identified an atherosclerotic cardiovascular disease cohort divided into those with and without a lipoprotein (a) test between 2019 and 2021. Baseline characteristics and lipid‐lowering therapy patterns were assessed. Multivariable regression modeling was used to determine factors associated with lipoprotein (a) testing. Among 595 684 patients with atherosclerotic cardiovascular disease, only 2587 (0.4%) were tested for lipoprotein (a). Those who were older or Black individuals were less likely to have lipoprotein (a) testing, while those with familial hypercholesterolemia, ischemic stroke/transient ischemic attack, peripheral artery disease, prior lipid‐lowering therapy, or low‐density lipoprotein cholesterol ≥130 mg/dL were more likely to be tested. Those with a lipoprotein (a) test, regardless of the lipoprotein (a) value, were more frequently initiated on any statin therapy (30.3% versus 10.6%, P

Hypertension is the most important risk factor for cardiovascular disease and the main cause of death worldwide. Some studies have reported a positive association between microalbuminuria and lipoprotein (a) with cardiovascular disease in hypertensive patients. Hence, the objective of this paper was to assess albuminuria and serum levels of Lipoprotein (a) (Lp [a]) and their correlation in hypertensive patients in a Government hospital in Warri, Delta State, Nigeria using appropriate standard techniques. Data collected showed that Thirty (15.0%) vs. 0 (0.0%) had microalbuminuria in the hypertensive and control groups respectively. The difference in the two groups was statistically significant (P-value =0.046). The mean urine albumin-creatinine ratio (UACR) were 1.02 ± 1.42 vs. 0.28 ± 0.16 mg/mmol in the hypertensive and control groups respectively. The difference in the two groups was statistically significant (

IntroductionThere is no consensus on the optimal concentration of lipoprotein(a) (Lp(a)) for the risk of atherosclerotic cardiovascular diseases (ASCVD) and aortic valve stenosis. In various clinical guidelines and agreed documents, the threshold level of Lp (a) is 30 mg/dl or 50 mg/dl. We estimated the cut-off value of Lp (a) associated with the risk of developing various localizations of atherosclerosis for the Central Asia, including Kazakhstani population.MethodsThis study was conducted at National Research Cardiac Surgery Center, Kazakhstan. 487 patients were included, of which 61.3% were men. The mean age of all participants was 57.3 ± 12.6 years. Bivariate and multivariable logistic regression analysis was used to study the relationship between risk factors and plasma lipoprotein (a) levels. The threshold value of lipoprotein (a) was predicted using the Youden index.ResultsFor Kazakhstani population the lipoprotein (a) cut offs for the risk of developing atherosclerotic CVD and aortic valve calcification was 21.1 mg/dl (p

Objective: Apolipoprotein B (ApoB) and lipoprotein (a) (Lp[a]) are predictors of cardiovascular disease (CVD) risk; therefore, current recommendations for CVD risk assessment and management advocate that patients receive testing for ApoB and Lp(a) in addition to the standard lipid panel. However, US guidelines around ApoB and Lp(a) testing have evolved over time and vary slightly by expert committee. The objective of this analysis was to estimate the number of insured individuals in the USA who received any component of a lipid test, or ApoB and/or Lp(a) testing, during 2019. Methods: We conducted a cross-sectional analysis to estimate the prevalence of any component of a lipid test, ApoB, and/or Lp(a) in the USA using four different claim data sources (including Medicaid, Medicare, and commercially insured enrollees). Prevalence estimates were age-, sex-, payor-, and region-standardized to the 2019 US Annual Social and Economic Supplement of the Current Population Survey. We also described the clinical profile of patients who received lipid testing between 2019 and 2021 (cohort analysis) in Optum claims database. Enrollees were grouped into four non-mutually exclusive cohorts based on their completion of any component of the lipid panel, ApoB, Lp(a), or ApoB and Lp(a). Results: In the prevalence cohort, over a third (38 %) of insured adults in the USA underwent testing for any component of a lipid panel in 2019. This proportion was higher for individuals aged ≥65 years compared to younger adults (62% vs 31 %). The proportion of ApoB and Lp(a) testing represented only

BackgroundIn recent years, the position of PCSK9 inhibitors as adjuvant therapy to statins in guidelines has further improved. However, there remained a dearth of direct comparative studies among different PCSK9 inhibitors. Therefore, this study aimed to conduct a network meta-analysis to evaluate the efficacy and safety of different PCSK9 inhibitors combined with statins.MethodsA comprehensive literature search was conducted from the study's inception to 12 November 2023, encompassing multiple online databases including PubMed, Embase, Cochrane Central, Web of Science, and ClinicalTrials.gov to obtain relevant randomized controlled trials. Frequentist network meta-analysis was employed to compare the efficacy and safety of different PCSK9 inhibitors. The efficacy endpoints were low-density lipoprotein cholesterol (LDL-C), apolipoprotein B (ApoB), and lipoprotein (a) (Lp(a)). The safety endpoints were any adverse events (AE), severe adverse events (SAE), AE leading to treatment discontinuation, and injection-site reaction.ResultsCompared with placebo and ezetimibe, all PCSK9 inhibitors demonstrated significant reductions in LDL-C levels. Notably, evolocumab exhibited the most pronounced effect with a treatment difference of −63.67% (−68.47% to −58.87%) compared with placebo. Regarding dosage selection for evolocumab, the regimen of 140 mg Q2W (−69.13%, −74.55% to −63.72%) was superior to 420 mg QM (−61.51%, −65.97% to −57.05%). Based on rankings and P-scores analysis, tafolecimab 150 mg Q2W demonstrated superior efficacy in reducing ApoB levels (−61.70%, −84.38% to −39.02%) and Lp(a) levels (−43%, 30%, −68%, 81% to −17%, 79%). Furthermore, the safety profile of PCSK9 inhibitors was favorable with no increase in the incidence of AE, SAE, or AE leading to treatment discontinuation; however, alirocumab, inclisiran, and tafolecimab may potentially entail a potential risk associated with injection-site reactions.ConclusionCompared with placebo and ezetimibe, PCSK9 inhibitors can significantly reduce LDL-C, ApoB, and Lp(a) when combined with statins to treat hypercholesterolemia. Furthermore, PCSK9 inhibitors and ezetimibe exhibit similar safety profiles.Systematic Review Registration[PROSPERO], identifier [CRD42023490506].

Lipoprotein(a) is a recognized risk factor for ASCVD. There is still no targeted therapy for Lp(a), however, drugs such as pelacarsen, olpasiran, zerlasiran, lepodisiran and muvalaplin are in clinical trials and have been shown to be effective in significantly reducing Lp(a) levels. Moreover, elevated Lp(a) levels significantly affect the prognosis of patients after aortic valve replacement (AVR) and heart transplantation (HTx). Therefore, the assessment of Lp(a) concentration in these patients will allow for a more accurate stratification of their cardiovascular risk, and the possibility of lowering Lp(a) will allow for the optimization of this risk. In this article, we summarized the most important information regarding the role of Lp(a) and lipid-lowering treatment in patients after AVR and HTx.

Dyslipidemia is a treatable risk factor for atherosclerotic cardiovascular disease that can be addressed through lifestyle changes and/or lipid-lowering therapies. Adherence to statins can be a clinical challenge in some patients due to statin-associated muscle symptoms and other side effects. There is a growing interest in integrative cardiology and nutraceuticals in the management of dyslipidemia, as some patients desire or are actively seeking a more natural approach. These agents have been used in patients with and without established atherosclerotic cardiovascular disease. We provide an updated review of the evidence on many new and emerging nutraceuticals. We describe the mechanism of action, lipid-lowering effects, and side effects of many nutraceuticals, including red yeast rice, bergamot and others.

Lipoprotein(a) (Lp(a)) has garnered increasing attention as a significant contributor to the pathogenesis of aortic stenosis (AS), prompting a focused investigation into innovative pharmacological strategies to target this lipoprotein and its associated risks. Despite its recognized role in AS progression, Lp(a) often remains overlooked in clinical assessments, mirroring the broader challenges observed in holistic disease management. This review delves into the mechanistic intricacies of Lp(a) involvement in AS pathophysiology and its potential as a therapeutic target. Drawing parallels with the imperative for healthcare providers to proactively engage with patients regarding treatment regimens, this review underscores the essential role of cardiologists and physicians in recognizing and addressing Lp(a) as a modifiable risk factor in AS management. Furthermore, it explores promising avenues of novel drug approaches, including emerging pharmacotherapies and targeted interventions, aimed at modulating Lp(a) levels and attenuating AS progression. By navigating the complexities of Lp(a) modulation and its implications for AS management, this review aims to bridge critical gaps in understanding and clinical practice, ultimately optimizing treatment strategies and improving patient outcomes in the realm of AS therapeutics.

Objective: Lipoprotein(a) [Lp(a)] has been associated with Atherosclerotic Cardiovascular Disease (ASCVD). Approximately 20 % of the population has elevated Lp(a). Despite its well-recognized role in ASCVD, universal screening remains controversial. The aim of our study is to investigate laboratory testing patterns for Lp(a) in subjects screened with a standard lipid panel at a large tertiary referring US institution. Methods: Data were retrospectively collected at Mayo Clinic from the Mayo Data Explorer (MDE). Subjects were included if they had a lipid panel measured between May 1, 2022, and April 30, 2023. Demographic data, Lp(a) measurements, statins and aspirin prescription and ASCVD events which occurred at any time in the life of a subject were recorded along with respective dates. The cumulative number of Lp(a) laboratory test orders were also tallied from 1994 to 2023 independently of the lipid panel requests. Results: Between May 1, 2022, and April 30, 2023, 257,225 subjects had a lipid panel ordered. Of these, only 386 (0.15 %) had Lp(a) tested within 1 year of the lipid panel, while 2406 (0.94 %) had Lp(a) tested at any time. Lp(a) was tested more frequently in males (67 %) and in subjects who developed Myocardial Infarction (MI) at any time (12 %). Following Lp(a) results, there was no significant change in statin or aspirin prescription associated with Lp(a) levels. Secondary prevention was the main setting for ordering Lp(a) testing, and there was no change in this trend throughout the years. Conclusions: Testing rates for Lp(a) in the general population are low and the main setting remains secondary prevention. Women are less tested than men. When Lp(a) is found to be elevated, often times there is no change in patient management to mitigate the ASCVD risk.

Objective To explore the causal relationship between lipoprotein (a) [Lp (a)] and cerebral small vascular disease (CSVD) by Mendelian randomization (MR) analysis. Methods Using genome-wide association study (GW AS) public database, the single nucleotide polymorphisms independently associated with Lp (a) (P < 5 X 10"8) were selected as instrumental variables (I Vs). The main outcomes of this study were white matter hyperintensity (WMH), cerebral micro hemorrhage, and lacunar infarction. Inverse variance weighted (IVW) mothod was used to evaluate the causal relationship between Lp (a) and CSVD, Sensitivity analysis was carried out by MR-Egger and MR-PRESSO to evaluate the pleiotropy of IVs. Furthermore, weighted median method, simple median method, and maximum likelihood ratio method were used to test the reliability of the results. Results IVW results showed that there was a positive risk relationship between Lp (a) and WMH (Oi=L083, 95%CI: 1.035-1.134, P < 0,001), but Lp(a) was not correlated with cerebral microhemorrhage (P=0.568) and lacunar infarction (P=0.651). MR-Egger analysis showed that the MR analysis of Lp (a) and WMH was not affected by horizontal pleiotropy (P=0.721). Conclusion MR analysis shows that Lp (a) is related to the increased risk of WMH. [ABSTRACT FROM AUTHOR]

Aim of the study. To investigate the relationship between serum lipoprotein (a) [Lp(a)] concentration and the risk of ischaemic stroke (IS) and its subtypes. Clinical rationale for the study. Lp(a) plays a role in atherogenic, pro-thrombotic, and antifibrinolytic processes. Elevated plasma Lp(a) is a strong independent risk factor for the development and progression of atherosclerotic disease. The association between lipoproteins and IS is more complex than that reported for cardiovascular diseases, with inconsistent and contradictory results from epidemiological studies. Material and methods. 231 patients with acute IS (defined as cases) and 163 age- and sex-matched control subjects were included in this prospective case-control study. Demographic and clinical variables (i.e. age, sex, smoking, presence of chronic diseases and concomitant medication) and laboratory data (i.e. concentrations of total cholesterol, high-density lipoprotein- -cholesterol, low-density lipoprotein-cholesterol, triglycerides, Lp(a), apolipoprotein A1, apolipoprotein B) were recorded. Results. The mean age and the percentage of men did not significantly differ between groups. Compared to controls, there was a significantly higher percentage of cases reported with concomitant diseases: diabetes mellitus, myocardial infarction, ischaemic heart disease, peripheral arterial disease, and atrial fibrillation. The study showed a significantly higher serum Lp(a) concentration in cases than in control subjects (81.81 nmol/L [c.32.7 mg/dL] vs. 59.75 nmol/L [c.23.9 mg/dL]; p = 0.036) and found an association between Lp(a) levels stratified by quartiles and the risk for ischaemic stroke (Q1 [Lp(a) < 13 nmol/L] vs. Q4 [Lp(a) > 117 nmol/L]: OR 2.23; 95% CI 1.23-4.03; p = 0.008). A subgroup analysis based on the TOAST classification of IS also showed a significant association between Lp(a) value of more than 75 nmol/L (30 mg/dL) and the risk of large-artery atherosclerosis stroke compared to the controls (OR 2.4; 95% CI 1.39-3.93; p = 0.001), as well as a statistically non-significant association with other subtypes of IS. The influence of Lp(a) remained significant even after adjusting for established risk factors for IS (OR 1.99; 95% CI 1.05-3.76; p = 0.04; respectively for the large-artery atherosclerotic subtype: OR 2.54; 95% CI 1.39-4.67; p = 0.003). Conclusion. We found that Lp(a) is an independent risk factor for ischaemic stroke, and for the large-artery atherosclerotic subtype of ischaemic stroke. [ABSTRACT FROM AUTHOR]

Dyslipidemia is one of the most common disorders worldwide, which, if left untreated, results in a multitude of complications. Thus proper diagnostics, which includes identifying of secondary causes of dyslipidemia is crucial. Endocrine disorders are an important cause of secondary dyslipidemia. This paper aims to review the publications on lipoprotein alterations in endocrine disorders from the past two years and provide an overview of the recent discoveries in this dynamically developing and large field. Significant changes in lipoprotein serum concentrations are present in most endocrinological diseases and can be modified with proper treatment. Some lipoproteins have also been proposed as markers in some endocrine diseases, e.g., thyroid carcinoma. From the scope of endocrine disorders, the largest number of studies explored the lipoprotein changes in polycystic ovary syndrome and in women during the menopausal and peri-menopausal period. Even though the association of thyroid disorders with dyslipidemia is already well studied, new research has delivered some exciting findings about lipoprotein alterations in euthyroid patients with either positive antithyroid peroxidase antibodies or reduced sensitivity to thyroid hormones. The problem of the adverse metabolic profile, including dyslipidemia in hypoprolactinemia has been recognized. Moreover, this review describes other significant discoveries encompassing lipoprotein alterations in disorders of the adrenals, thyroid, parathyroid glands, pituitary, and gonads. The up-to-date knowledge of the influence of endocrine disorders and hormonal changes on serum lipoproteins is prudent as it can significantly impact therapeutic decisions. [ABSTRACT FROM AUTHOR]

BackgroundLipoprotein(a) [Lp(a)] is a genetically determined risk factor for atherosclerotic cardiovascular disease (CVD). Limited data are available on Lp(a) testing from the Middle-East region. Therefore, we aim to evaluate the utilization and yield of Lp(a) testing over time and characterize CVD profiles of patients with abnormal Lp(a) tasting at a single-quaternary-care center in the United Arab Emirates.MethodsUnique Lp(a) tests conducted between 07/2017 and 10-2023 were included. Overtime trends in Lp(a) test utilization and abnormal Lp(a) [defined as Lp(a) > 125 nmol/L] test findings were described. CVD rates in patients with abnormal Lp(a) were compared to those with Lp(a) ≤ 125 nmol/L using appropriate methods.ResultsIn our center, 0.95% of the patients (n = 5,677) had their Lp(a) measured, with a median level of 32 [11–82] nmol/L. Lp(a) was abnormal in 15.9% of the tests. Over the years 2018–2022, there was a 109% increase in Lp(a) testing, with concomitant up-trends in findings of abnormal Lp(a) (11.8% to 16.4%, P = 0.02). Compared to patients with Lp(a) ≤ 125 nmol/I, those with abnormal Lp(a) had higher rates of any prevalent CVD (34% vs. 25.1%, P

Abstract Background Biliary tract cancers have garnered significant attention due to their highly malignant nature. The relationship between abnormal lipid metabolism and tumor occurrence and development is a research hotspot. However, its correlation with biliary tract cancers is unclear. Methods We enrolled 78 patients with biliary tract cancers and obtained data on clinical characteristics, pathological findings, and preoperative blood lipid indices, including total cholesterol (TC), high‐density lipoprotein cholesterol (HDL‐C), low‐density lipoprotein cholesterol (LDL‐C), triglycerides (TG), and lipoprotein (a) [Lp(a)]. Receiver operating characteristic (ROC) curves were used to determine the optimal predictive cutoff values of lipid indicators among the participants. Independent risk factors were determined using Cox regression, and survival was predicted using the Kaplan–Meier method. Statistical analyses were performed using SPSS software. Results Univariate Cox regression analysis revealed that the body mass index (BMI), tumor location, surgical margin, N stage, and abnormally increased LDL‐C, TG, and Lp(a) levels were significantly associated with poor prognosis of biliary tract cancers (p

Background: Lipoprotein (a) [Lp(a)] is associated with coronary artery disease (CAD). However, the role of healthy lifestyle against the risk of CAD with consideration of high Lp(a) levels remains unclear. Methods: This study examined 4512 participants who underwent serum Lp(a) level assessment at Kanazawa University Hospital from 2008 to March 2016. Their lifestyle habits were examined based on four questionnaires regarding dietary pattern, exercise habits, smoking status and body weight. Logistic regression analyses were performed to identify the association between healthy lifestyle and CAD independent of Lp(a) levels. Results: The Lp(a) levels were significantly associated with CAD (odds ratio [OR]: 1.12, 95% confidence interval [CI]: 1.08–1.17, p = 1.3 × 10−7per 10 mg/dL). Under these circumstances, the lifestyle risk score was also significantly associated with CAD (OR: 1.24, 95% CI: 1.12–1.36, p = 2.4 × 10−8). Compared with patients with a favourable lifestyle who have Lp(a) levels of <30 mg/dL, those with an intermediate or unfavourable lifestyle were at higher risk for CAD (OR: 1.11, 95% CI: 1.02–1.20, p = 0.003 and OR: 1.40, 95% CI: 1.16–1.54, p = 3.6 × 10−5, respectively). Further, patients with a favourable, intermediate or unfavourable lifestyle who have Lp(a) levels of ≥30 mg/dL were at high risk for CAD (OR: 1.21, 95% CI: 1.08–1.34, p = 0.0014; OR: 1.31, 95% CI: 1.14–1.48, p = 1.2 × 10−4; and OR: 1.81, 95% CI: 1.44–2.18, p = 2.2 × 10−7, respectively). Conclusions: Healthy lifestyle was associated with a lower risk of CAD regardless of Lp(a) levels. [ABSTRACT FROM AUTHOR]

• Tibolone administration significantly decreased ApoA-I. • Tibolone administration significantly decreased lipoprotein (a). • Treatment with tibolone did not impact ApoA- II and ApoB. Tibolone is a synthetic steroid with estrogenic, androgenic and progestogenic properties that is used as hormone replacement therapy (HRT) in postmenopausal women. Treatment with tibolone has been demonstrated to lead to changes of the lipid profile, including alterations in lipoprotein (a) and apolipoprotein levels. Hence, we conducted the present meta -analysis of randomized controlled trials (RCTs) to assess the effect of tibolone treatment on apolipoproteins and lipoprotein (a) values in postmenopausal women. Several databases (Cochrane Library, PubMed/Medline, Scopus, and Google Scholar) were searched for English-language manuscripts published up to September 2023 that scrutinized the effects of tibolone administration on apolipoprotein A-I (ApoA-I), apolipoprotein A-II (ApoA-II), apolipoprotein B (ApoB), and lipoprotein (a) in postmenopausal women. The results were reported as the weighted mean difference (WMD) with a 95% confidence interval (CI), generated using a random-effects model. Finally, 12 publications with 13 RCT arms were included in the current meta -analysis. The overall results from the random-effects model demonstrated a notable reduction in ApoA-I (n = 9 RCT arms, WMD: −34.96 mg/dL, 95 % CI: −42.44, −27.48, P < 0.001) and lipoprotein (a) (n = 12 RCT arms, WMD: −7.49 mg/dl, 95 % CI: −12.17, −2.81, P = 0.002) after tibolone administration in postmenopausal women. However, treatment with tibolone did not impact ApoA- II (n = 4 RCT arms, WMD: 1.32 mg/dL, 95 % CI: −4.39, 7.05, P = 0.64) and ApoB (n = 9 RCT arms, WMD: −2.68 mg/dL, 95 % CI: −20.98, 15.61, P = 0.77) values. In the subgroup analyses, we noticed a notable decrease in lipoprotein (a) levels when tibolone was prescribed to females aged < 60 years (WMD: −10.78 mg/dl) and when it was prescribed for ≤ 6 months (WMD: −15.69 mg/dl). The present meta -analysis of RCTs highlighted that treatment with tibolone reduces lipoprotein (a) and apolipoprotein A-I levels in postmenopausal women. As the decrease in serum lipids' concentrations is associated with a decrease in the risk of cardiovascular disease (CVD), treatment with tibolone could be a suitable therapy for postmenopausal women with elevated CVD risk. [ABSTRACT FROM AUTHOR]

Background Lipoprotein (a) [Lp(a)] is a robust predictor of coronary heart disease outcomes, with targeted therapies currently under investigation. We aimed to evaluate the association of high Lp(a) with standard modifiable risk factors (SMuRFs) for incident first acute myocardial infarction (AMI). Methods and Results This retrospective study used the Mass General Brigham Lp(a) Registry, which included patients aged ≥18 years with an Lp(a) measurement between 2000 and 2019. Exclusion criteria were severe kidney dysfunction, malignant neoplasm, and prior known atherosclerotic cardiovascular disease. Diabetes, dyslipidemia, hypertension, and smoking were considered SMuRFs. High Lp(a) was defined as >90th percentile, and low Lp(a) was defined as

BackgroundElevated lipoprotein (a) level was recognized as an independent risk factor for significant adverse cardiovascular events in acute coronary syndrome (ACS) patients. Despite this recognition, the consensus in the literature regarding the prognostic significance of elevated lipoprotein (a) in ACS was also limited. Consequently, we conducted a thorough systematic review and meta-analysis to evaluate the prognostic relevance of elevated lipoprotein (a) level in individuals diagnosed with ACS.Methods and resultsA thorough literature review was conducted by systematically searching PubMed, Embase, and Cochrane databases until September 2023. This review specifically examined cohort studies exploring the prognostic implications of elevated lipoprotein (a) level in relation to major adverse cardiovascular events (MACE), including death, stroke, non-fatal myocardial infarction (MI), and coronary revascularization, in patients with ACS. The meta-analysis utilized aggregated multivariable hazard ratios (HR) and their respective 95% confidence intervals (CI) to evaluate prognostic implications between high and low lipoprotein (a) levels [the cut-off of high lipoprotein (a) level varies from 12.5 to 60 mg/dl]. Among 18,168 patients in the identified studies, elevated lipoprotein (a) was independently associated with increased MACE risk (HR 1.26; 95% CI: 1.17–1.35, P

Dyslipidemia is one of the most common disorders worldwide, which, if left untreated, results in a multitude of complications. Thus proper diagnostics, which includes identifying of secondary causes of dyslipidemia is crucial. Endocrine disorders are an important cause of secondary dyslipidemia. This paper aims to review the publications on lipoprotein alterations in endocrine disorders from the past two years and provide an overview of the recent discoveries in this dynamically developing and large field. Significant changes in lipoprotein serum concentrations are present in most endocrinological diseases and can be modified with proper treatment. Some lipoproteins have also been proposed as markers in some endocrine diseases, e.g., thyroid carcinoma. From the scope of endocrine disorders, the largest number of studies explored the lipoprotein changes in polycystic ovary syndrome and in women during the menopausal and peri-menopausal period. Even though the association of thyroid disorders with dyslipidemia is already well studied, new research has delivered some exciting findings about lipoprotein alterations in euthyroid patients with either positive antithyroid peroxidase antibodies or reduced sensitivity to thyroid hormones. The problem of the adverse metabolic profile, including dyslipidemia in hypoprolactinemia has been recognized. Moreover, this review describes other significant discoveries encompassing lipoprotein alterations in disorders of the adrenals, thyroid, parathyroid glands, pituitary, and gonads. The up-to-date knowledge of the influence of endocrine disorders and hormonal changes on serum lipoproteins is prudent as it can significantly impact therapeutic decisions.

Background and aimsIn the non-metropolitan region of Brandenburg (Germany), which is characterized by high rates of cardiovascular diseases and underserved medical care, there is a lack of awareness regarding lipoprotein(a) [Lp(a)] as a risk factor. In addition, data from patients with atherosclerotic cardiovascular disease (ASCVD) in diverse regional backgrounds, including the understudied Brandenburg cohort, and various healthcare statuses remain insufficient.MethodsIn this WalkByLab study, Lp(a) levels were monitored in a non-metropolitan cohort (n = 850) in Brandenburg, Germany, comprising 533 patients at high cardiovascular risk and 317 healthy controls. Patients underwent a comprehensive angiological screening, which included blood serum analysis, assessment of medical and family history, cardiovascular risk, and disease status, and evaluation of lifestyle and quality of life. All parameters were evaluated with regard to two groups based on Lp(a) levels: low (

INTRODUCTION: Posterior circulation ischemia syndrome is a common feature of the poor blood flow to the posterior cerebral regions which is generally caused by atherosclerotic involvement of vertebral arteries (VA). However, the risk factors for VA atherosclerosis remain largely unknown. Lipoprotein (a) (Lp(a)), a modified low-density lipoprotein, has been implicated as a risk factor for coronary and peripheral artery disease. Our aim was to investigate the possible association of Lp(a) with low vertebral artery flow, a marker representing VA atherosclerosis. METHODS: An institutional registry database was used for the present study. A complete dataset, including Doppler ultrasound imaging of the carotid and VA was available in 135 of 718 cases, and these cases were included in the analysis. RESULTS: 29 (21.1%) patients had Lp(a)>30 mg/dL, and total VA flow in these patients was significantly less than in patients with Lp(a)

Abstract Background In addition to proatherogenic properties, lipoprotein (a) (Lp(a)) has also pro-inflammatory, antifibrinolytic and prothrombogenic features. The aim of the current study was to identify the predictors of functional and morphological properties of the arterial wall in patients after myocardial infarction and increased Lp(a) levels at the beginning and after treatment with proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors. Methods Seventy-six post-myocardial infarction patients with high Lp(a) levels were included in the study. Ultrasound measurements of flow-mediated dilation of brachial artery (FMD), carotid intima-media thickness (c-IMT) and pulse wave velocity (PWV) were performed initially and after 6 months of treatment. At the same time points lipids, Lp(a), inflammatory and hemostasis markers were measured in blood samples. Results In linear regression model FMD significantly correlated with age at first myocardial infarction (β = 0.689; p = 0.022), high-sensitivity C-reactive protein (β = -1.200; p = 0.009), vascular cell adhesion protein 1 (VCAM-1) (β = -0.992; p = 0.006), overall coagulation potential (β = 1.428; p = 0.014) and overall hemostasis potential (β = -1.473; p = 0.008). c-IMT significantly correlated with age at first myocardial infarction (β = 0.574; p = 0.033) and Lp(a) (β = 0.524; p = 0.040). PWV significantly correlated with systolic blood pressure (β = 0.332; p = 0.002), tumor necrosis factor alpha (β = 0.406; p = 0.002), interleukin-8 (β = -0.315; p = 0.015) and plasminogen activator inhibitor 1 (β = 0.229; p = 0.031). After treatment FMD reached statistical significance only in univariant analysis with systolic blood pressure (r = -0.286; p = 0.004) and VCAM-1 (r = -0.229; p = 0.024). PWV and c-IMT correlated with age (r = 0.334; p = 0.001 and r = 0.486; p

Bingyan Yu,1,2,&ast; Xiangming Hu,2,&ast; Jieliang Liu,2 Zhiqiang Nie,3 Ci Ren Luo Bu,4 Guang Li,2 Yingling Zhou,2 Haojian Dong2,4 1School of Medicine, South China University of Technology, Guangzhou, People’s Republic of China; 2Department of Cardiology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People’s Republic of China; 3Department of Cardiology, Hypertension Research Laboratory, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People’s Republic of China; 4Nyingchi People’s Hospital, Nyingchi, Tibet, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Haojian Dong, Department of Cardiology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, People’s Republic of China, Tel +862083827812, Fax +862083827812, Email donghaojian@gdph.org.cnPurpose: Lipoprotein(a) (Lp[a]) is well-known as a residual risk factor for coronary artery disease (CAD). However, the different adverse effects of Lp(a) about CAD in patients with or without type 2 diabetes mellitus (T2DM) are unclear. This study aimed to investigate the Lp(a) thresholds for CAD diagnosis in T2DM and non-T2DM patients, and further compare the Lp(a) alarm values along with optimal low-density lipoprotein cholesterol (LDL-C) level.Methods: This retrospective study consecutively enrolled patients with suspected CAD who underwent coronary angiography in Guangdong Provincial People’s Hospital between September 2014 and July 2015. A logistic regression model was established to explore the association of Lp(a) and CAD in patients. Restricted cubic splines were used to compare the threshold values of Lp(a) for CAD in patients with and without T2DM, and further in optimal LDL-C level situation.Results: There were 1522 patients enrolled finally. After multivariable adjustment, Lp(a) was an independent risk factor for CAD in patients with T2DM (odds ratio [OR]: 1.98, 95% CI]: 1.12– 3.49, p = 0.019) and without T2DM (OR: 3.42, 95% CI: 2.36– 4.95, p < 0.001). In the whole population, the Lp(a) threshold of CAD was 155, while 145 mg/L for T2DM and 162 mg/L for non-T2DM ones, respectively. In patients with LDL-C< 1.8 mmol/l, the alarm value of Lp(a) was even lower in T2DM than non-T2DM patients (155 vs 174 mg/L).Conclusion: Lp(a) was a significant residual risk for CAD in patients whether with T2DM or not. And Lp(a) had a lower alarm value in T2DM patients, especially in optimal LDL-C level.Keywords: lipoprotein(a), coronary artery disease, type 2 diabetes mellitus, low-density lipoprotein cholesterol

Background: Polycystic ovarian syndrome (PCOS) is a multifactorial endocrine disorder which along with insulin resistance leads to infertility and metabolic syndrome (MetS). This increases the cardiovascular risk in PCOS patients. Aims and Objectives: The study was undertaken with the objective to assess and compare the levels of insulin, HOMA IR, lipoprotein (a), and comprehensive lipid tetrad index (CTLI) in PCOS patients with and without MetS and, thus, to compare the cardiovascular disease risk in the two groups. Materials and Methods: Seventy-one freshly diagnosed cases of women with PCOS were enrolled in the study. The patients were grouped into PCOS with MetS and PCOS without MetS with 32 women in each group, matched by age. Biochemical parameters were analyzed in blood chemistry autoanalysers. Insulin, lipoprotein (a), was estimated using ELISA. HOMA IR and CTLI were calculated using standard formulae. Results: About 48.6% of the patients with PCOS had MetS which developed at a mean age of 25 years. Blood glucose and lipid profile parameters were significantly higher, while high-density lipoprotein levels were lower in the group with MetS. Lipoprotein (a) and CTLI were also significantly higher in PCOS patients with MetS than in those without MetS. Insulin and HOMA IR, though higher in the PCOS with MetS group than in the PCOS without MetS, there was no significant statistical difference. Conclusion: There is a higher risk of developing cardiovascular disease in PCOS women with MetS than in the PCOS women without MetS at a relatively younger age.

Cardiovascular diseases (CVD) continue to be the main cause of death in our country. Adequate control of lipid metabolism disorders is a key challenge in cardiovascular prevention that is far from being achieved in real clinical practice. There is a great heterogeneity in the reports of lipid metabolism from Spanish clinical laboratories, which may contribute to its poor control. For this reason, a working group of the main scientific societies involved in the care of patients at vascular risk, has prepared this document with a consensus proposal on the determination of the basic lipid profile in cardiovascular prevention, recommendations for its realization and unification of criteria to incorporate the lipid control goals appropriate to the vascular risk of the patients in the laboratory reports.

Abstract Background and aims Lipoprotein (a) [Lp(a)] is a genetically regulated lipoprotein particle that is an independent risk factor for coronary atherosclerotic heart disease. However, the correlation between Lp(a) and left ventricular ejection fraction (LVEF) in patients with myocardial infarction (MI) has been poorly studied. The present study investigated the correlation between Lp(a) and LVEF, as well as the impact of Lp(a) on long-term mortality in patients with MI. Methods Patients who underwent coronary angiography resulting in MI diagnosis between May 2018 and March 2020 at the First Affiliated Hospital of Anhui Medical University were included in this study. The patients were divided into groups based on the Lp(a) concentration and LVEF (reduced ejection fraction group: 455 mg/L was the best predictive value for reduced ejection fraction (AUC: 0.7694, P

Background: Lipoprotein a (LP(a)), an LDL-like lipoprotein, known as a risk factor for cardiovascular diseases, has a controversial association with diabetic retinopathy in patients with type 2 diabetes—the current systematic review aimed to critically assess the association between LP(a) and diabetic retinopathy. Methods: A systematic review of relevant studies was conducted after a thorough search in PubMed, Scopus, and Google Scholar electronic databases. We used English observational, case-control, and prospective cohort studies published up to August 2022, including type 2 diabetic patients as the population, diabetic retinopathy as the outcome, and LP(a) as the intervention. Result: 17 relevant studies, including 4688 patients with diabetes, were included in this systematic review. While in 13 studies, Lipoprotein(a) was recognized as a risk factor for diabetic retinopathy, only three studies reported no evidence of a relationship between the two. Also, another study showed a mixed outcome of the relationship between LP(a) and diabetic retinopathy. Conclusion: High serum lipoprotein(a) in patients with type 2 diabetes is considered a risk factor for diabetic retinopathy. However, further large-scaled cohort studies are still required to validate this finding. [ABSTRACT FROM AUTHOR]

Lipoprotein(a) (Lp(a)) molecule includes two protein components: apolipoprotein(a) and apoB100. The molecule is the main transporter of oxidized phospholipids (OxPL) in plasma. The concentration of this strongly atherogenic lipoprotein is predominantly regulated by the LPA gene expression. Lp(a) is regarded as a risk factor for several cardiovascular diseases. Numerous epidemiological, clinical and in vitro studies showed a strong association between increased Lp(a) and atherosclerotic cardiovascular disease (ASCVD), calcific aortic valve disease/aortic stenosis (CAVD/AS), stroke, heart failure or peripheral arterial disease (PAD). Although there are acknowledged contributions of Lp(a) to the mentioned diseases, clinicians struggle with many inconveniences such as a lack of well-established treatment lowering Lp(a), and common guidelines for diagnosing or assessing cardiovascular risk among both adult and pediatric patients. Lp(a) levels are different with regard to a particular race or ethnicity and might fluctuate during childhood. Furthermore, the lack of standardization of assays is an additional impediment. The review presents the recent knowledge on Lp(a) based on clinical and scientific research, but also highlights relevant aspects of future study directions that would approach more suitable and effective managing risk associated with increased Lp(a), as well as control the Lp(a) levels. [ABSTRACT FROM AUTHOR]

Purpose of Review: The goal of this review is to present the pharmacodynamic effectiveness as well as the clinical efficacy and safety of investigational antisense oligonucleotides (ASOs) and small interference RNAs (siRNAs) drugs that specifically target lipoprotein(a) (Lp(a)). The review will discuss whether the existing lipid-lowering therapies are adequate to treat high Lp(a) levels or whether it is necessary to use the emerging new therapeutic approaches which are based on the current RNA technologies. Recent Findings: Lipoprotein(a) (Lp(a)) is a causal risk factor for atherosclerotic cardiovascular disease (ASCVD), independent of other conventional risk factors. High Lp(a) levels are also independently associated with an increased risk of aortic stenosis progression rate. Plasma Lp(a) levels are primarily genetically determined by variation in the LPA gene coding for apo(a). All secondary prevention trials have demonstrated that the existing hypolipidemic therapies are not adequate to reduce Lp(a) levels to such an extent that could lead to a substantial reduction of ASCVD risk. This has led to the development of new drugs that target the mRNA transcript of LPA and efficiently inhibit Lp(a) synthesis leading to potent Lp(a) reduction. These new drugs are the ASO pelacarsen and the siRNAs olpasiran and SLN360. Recent pharmacodynamic studies showed that all these drugs potently reduce Lp(a) up to 98%, in a dose-dependent manner. Ongoing clinical trials will determine the Lp(a)-lowering efficacy, tolerability, and safety of these drugs as well as their potential effectiveness in reducing the ASCVD risk attributed to high plasma Lp(a) levels. Summary: We are not ready today to significantly reduce plasma Lp(a). Emerging therapies potently decrease Lp(a) and ongoing clinical trials will determine their effectiveness in reducing ASCVD risk in subjects with high Lp(a) levels. [ABSTRACT FROM AUTHOR]