The Peter Attia Drive

#24 - Tom Dayspring, M.D., FACP, FNLA – Part V of V: Lp(a), inflammation, oxLDL, remnants, and more

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Oct 19, 2018
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INSIGHT

Lp(a) Measurement

  • Lp(a) mass is a less effective metric than Lp(a) particle count.
  • Lp(a) particle number is best measured by electrophoresis and immunostaining, not NMR.
INSIGHT

Lp(a) and Treatments

  • Statins lower LDL particles without apo(a), but not Lp(a) particles.
  • Niacin and PCSK9 inhibitors can lower Lp(a), but their use for this purpose is debated.
ADVICE

Pro-Oxidative Biomarkers

  • Use oxLDL, myeloperoxidase (MPO), or F2-isoprostanes to assess pro-oxidative states.
  • Avoid Lp-PLA2 as a pro-oxidative biomarker due to poor data and lack of outcome correlation.
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