Core IM | Internal Medicine Podcast
#174 Lp(a) and ASCVD Risk: 5 Pearls Segment
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Quick takeaways
- Lipoprotein(a) is genetically determined and poses a significant independent risk for atherosclerotic cardiovascular disease, necessitating specific testing and management strategies.
- Effective management of elevated LP(a) levels involves controlling other cardiovascular risk factors and counseling patients on lifestyle modifications and their overall health.
Deep dives
Understanding LP(a) and Its Unique Characteristics
LP little a (LP(a)) is a distinct subtype of low-density lipoprotein (LDL) that poses an independent risk for atherosclerotic cardiovascular disease (ASCVD). Unlike traditional LDL particles, LP(a) is genetically determined and characterized by the presence of a specific apolipoprotein A molecule on its surface, which contributes to heightened cardiovascular risks. Research has shown that individuals with elevated LP(a) levels face a significantly greater likelihood of coronary artery disease, with studies indicating a 2.3-fold increase in heart attack risk for those exceeding 50 mg/dL. The pathophysiological mechanisms of LP(a) include increased oxidation of phospholipids, pro-inflammatory properties, and the promotion of thrombosis, which collectively enhance its pro-atherogenic role.
