Page 5 - Dyslipidaemia_newsletter8_2024_Final

REFLECTIONS
Dyslipidaemia
Dyslipidaemia Global Newsletter #8 2024

The authors also analysed joint effects and combined effects
models, which took into account two or more biomarkers on Dyslipidaemia
cardiovascular events. They found that a single combined
measure of high-sensitivity CRP, LDL-C, and lipoprotein(a)
levels predicted incident CV events over a 30-year period.
This could have implications for diagnostics, wellness
interventions, and the selection of targeted therapy. These
data also support efforts to extend strategies for the primary
prevention of atherosclerotic events beyond traditional 10-
year estimates of risk.

While lifestyle changes, such as diet, exercise, smoking
cessation, and stress reduction, can lower high-sensitivity
CRP and LDL-C, they usually don’t affect lipoprotein(a) levels,
as these are primarily dictated by genetics.

In terms of pharmacologic interventions, lowering LDL-C
with medication significantly reduces CV risk and is the most
crucial tool beyond lifestyle changes. However, the cumulative CLINICAL PEARLS FROM THE FACULTY
incidence curves revealed that major CV events continued
to accumulate over time, despite the cohort having access to
quality care and over half being on statins at 30 years. This
underscores the ongoing need to lower LDL-C levels with both
statins and additional lipid-lowering agents. Moreover, numerous
outcome trials are currently underway, testing new agents that
substantially lower lipoprotein(a) levels. Therefore, evaluating
LDL-C, high-sensitivity CRP, and lipoprotein(a) levels together
could help clinicians choose appropriate pharmacologic agents
for sustained atherosclerosis protection.

WATCH
PROF. LAVALLE COBO DISCUSS
CLICK HERE THE CLINICAL RELEVANCE OF THIS
FOR THE LINK TO FULL ARTICLE ARTICLE.

Lipoprotein(a) and cardiovascular disease.
Nordestgaard BG, Langsted A. Lancet. 2024 Sep 12:S0140-6736(24)01308-4.

High Lp(a) is a significant, genetically determined CV risk factor affecting a substantial portion of the global population. Approximately
20% of people worldwide face a high risk of atherosclerotic CVD and aortic valve stenosis due to elevated lipoprotein(a) levels.
These levels are lowest among individuals from East Asia, Europe, and Southeast Asia, moderate in those from South Asia, the
Middle East, and Latin America, and highest in individuals from Africa. Over 90% of Lp(a) concentrations are genetically determined
and are 17% higher in postmenopausal women compared to men.

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