Medical researchers have known for some time that a high level of lipoprotein-a, or LP(a), in your bloodstream is a risk factor for heart disease.
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A new study has found that when added to a traditional lipid panel – a blood test that measures lipids – measurements of apparently healthy patients’ blood levels of LP(a) can help doctors more accurately predict the patient’s risk of developing heart disease over the next 15 years.
The assessment is particularly useful for people who have a medium-level risk of developing heart disease.
Researchers say these findings, coupled with recent genetic studies similarly pointing toward LP(a) as a cause of heart disease, could lead to medications that lower LP(a) levels – and help to stave off development of heart disease for people who haven’t yet developed it.
Researchers at Innsbruck Medical University in Innsbruck, Austria measured the LP(a) levels in more than 800 healthy men and women and followed them for 15 years.
They looked at how accurate existing risk factors and blood tests are at predicting which people were at a lower risk versus those who were at higher risk for developing heart disease.
They found that adding an initial baseline LP(a) measurement greatly improved the ability to reclassify 40 percent of the study participants as high- or low-risk.
In fact, the LP(a) measurement helped to better predict a person’s risk for developing heart disease, even as long as 15 years later.
Fine-tuning patient assessments
Lipoproteins are molecules made of proteins, cholesterol and fat. They are the major carriers of cholesterol and similar substances through the blood.
Stanley Hazen, MD, PhD, Head of the Section for Preventive Cardiology, said that this assessment would be of great value for general practitioners in helping to determine a patient’s chance of developing cardiovascular disease. Dr. Hazen did not take part in the study.
“What this data showed is that LP(a) significantly added to the existing risk factors and the existing blood tests to help fine-tune risk assessment, and really home in on who is at greater versus less risk for developing cardiovascular disease,” Dr. Hazen says.
“Because LP(a) levels change by only 10 percent to 20 percent over a lifetime, getting just a single measure of LP(a) can help to identify those for whom more aggressive preventive efforts may yield the most benefit for a lifetime,” Dr. Hazen says.
LP(a) levels are highly inheritable, Dr. Hazen says. Anyone with an elevated level should let their first-degree relatives, such as parents, children or siblings, know they also should seek screening with LP(a) testing.
“I think LP(a) testing should become part of our standard initial risk assessment early in adulthood – when preventive efforts for those most in need will have the largest benefit,” Dr. Hazen says. “You can reduce your cardiovascular risks by lowering your cholesterol, monitoring blood pressure and insuring that your blood sugars are well-controlled.”
Complete findings for the study, “Discrimination and Net Reclassification of Cardiovascular Risk with Lipoprotein (A)” appear in The Journal of the American College of Cardiology.
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