Core IM | Internal Medicine Podcast #174 Lp(a) and ASCVD Risk: 5 Pearls Segment
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Apr 2, 2025 Dr. Steve Nissen from Cleveland Clinic, a leading figure in lipoprotein(a) research, joins Dr. Greg Katz from NYU to delve into crucial insights about this underappreciated lipid layer. They discuss why Lp(a) is essential for evaluating cardiovascular risk and who should be tested. Listeners will learn about interpreting results, managing elevated levels, and the potential roles of aspirin and PCSK9 inhibitors. The episode highlights the evolving strategies in understanding and treating Lp(a), offering a fresh perspective on patient care.
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Lp(a) Uniqueness
- Lp(a) is a unique subtype of LDL cholesterol, carrying apolipoprotein(a).
- This structural difference significantly increases cardiovascular risk.
Lp(a) Testing Recommendations
- Test Lp(a) in patients with unexplained MI/stroke or familial hypercholesterolemia.
- Also test those with recurrent ASCVD despite optimal management or intermediate primary prevention risk.
Interpreting Lp(a) Levels
- Lp(a) levels are measured in either nanomoles per liter or milligrams per deciliter, and assays differ.
- Particle assays (nanomoles/L) are preferred as they measure total Lp(a) particles, not just mass.