Home HOME Cardiology Letters 2020 Cardiology Letters Vol.29, No.4, p.240–242, 2020

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Cardiology Letters Vol.29, No.4, p.240–242, 2020

Title: Je dôležité znížiť aj „Lipoproteín a“ [Lp(a)] pri sekundárnej prevencii kardiovaskulárnej morbidity a mortality? / Is it important to reduce serum levels of Lp(a) in secondary prevention of cardiovascular morbidity and mortality?
Author: J. Murín, J. Bulas, M. Wavruch

Abstract:

Abstrakt. Ovplyvnenie sérových lipidov, osobitne LDL-Ch hypolipidemickou liečbou (statíny, prípadne s ezetipibom, v osobitných prípadoch aj PCSK9 inhibítory) redukuje kardiovaskulárnu (KV) morbiditu a mortalitu. Dnes chceme dosahovať v sekundárnej KV prevencii ešte nižšie sérové hladiny LDL-Ch a chceme to dosiahnuť aj oveľa skôr v živote pacientov.
Objavili sa aj novšie sérové lipidy, a takým je sérová hladina Lipoproteínu a [Lp(a)], ktoré boli skúmané vzhľadom na súvislosť hladiny Lp(a) s KV aterosklerotickými ochoreniami. Zistilo sa, že to nie je marker KV ochorení, ale rizikový faktor. Donedávna sme však nevedeli redukovať sérovú hladinu Lp(a), ale nedávno sa preukázalo, že PCSK9 inhibítory (redukujúce sérovú hladinu LDL-Ch) sú schopné redukovať aj sérovú hladinu Lp(a) a u osôb po akútnom koronárnom syndróme, liečených alirokumabom (štúdia ODYSSEY OUTCOMES), redukovali výskyt KV príhod u tých pacientov v najvyššom kvartile sérovej hladiny Lp(a) práve aj redukciou tejto zvýšenej hladiny.
Takže v blízkej budúcnosti sa možno stane zisťovanie sérovej hladiny Lp(a) dôležitým a osobitne u osôb s KV ochorením. Lit. 19, on-line full text (Free, PDF) www.cardiologyletters.sk

Abstract. Reduction of serum lipids, mainly of LDL-Ch level, with lipid lowering treatments (statins, event with ezetimibe and PCSK9 inhibitors in special patients) reduces cardiovascular (CV) morbidity and mortality. These days we want, in secondary CV prevention, to lower serum LDL-Ch levels even more and we also want to start with this treatment very much earlier.
There are also other new serum lipids, and Lp(a) is one of them, and an association of its serum levels with CV atherosclerotic diseases was found. It is not a (bio)marker, but a risk factor. Up to now we have not had the possibility to reduce serum levels of Lp(a), but treatment with PCSK9 inhibitors recently documented not only a great reduction of serum levels of LDL-Ch but also serum levels of Lp(a): patients after acute coronary syndrome were treated with alirocumab (ODYSSEY OUTCOMES Study), there was great reduction of CV events and the reduction of serum levels of Lp(a) in patients in the highest quartile of these levels contributed to this benefit.
In the near future we expect that examination of serum levels of Lp(a) will be important, mostly in patients with CV disease. Ref. 19, on-line full text (Free, PDF) www.cardiologyletters.sk



Keywords: Lp(a), kardiovaskulárne aterosklerotické ochorenia, PCSK9 inhibítory, redukcia KV morbidity a mortality / Lp(a), cardiovascular atherosclerotic disease, PCSK9 inhibitors, reduction of CV morbidity and mortality
Published online: 15-Oct-2020
Year: 2020, Volume: 29, Issue: 4 Page From: 240, Page To: 242
doi:10.4149/Cardiol_2020_4_7


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