| Title: |
Hyperlipoproteinemia(a) in coronary artery disease patients: who are patients with very high levels and how do they respond to the PCSK9 antibody therapy? |
| Authors: |
Novakovic, M; Trsan, J; Krevel, B; Cevc, M; Fras, Z; Jug, B |
| Source: |
European Heart Journal ; volume 44, issue Supplement_2 ; ISSN 0195-668X 1522-9645 |
| Publisher Information: |
Oxford University Press (OUP) |
| Publication Year: |
2023 |
| Description: |
Introduction Lipoprotein(a) [Lp(a)] is a considerable risk factor for coronary artery disease [CAD] and a possible target for novel risk management therapy. On the one hand, increased Lp(a) levels may help select at-risk CAD patients who are better candidates for PCSK9 antibody therapy; on the other hand, PCSK9 antibody therapy has been shown to reduce Lp(a) levels. Purpose The aim of our study was two-fold: i) to appraise the prevalence and characteristics of CAD patients with elevated Lp(a), and ii) to identify possible predictors of Lp(a) levels reduction in CAD patients on PCK9 antibody therapy. Methods Consecutive patients with established CAD referred for cardiac rehabilitation from 2020 to 2022 were included and had Lp(a) serum levels measured using the Lp(a) assay on the RX Daytona+ automated biochemistry analyzer. Clinical and demographic predictors of Lp(a) >50 mg/dL and >100 mg/dL were assessed (namely age, sex and traditional risk factors). Furthermore, in patients with CAD and increased Lp(a) levels (>100 mg/dL, which makes them eligible for full reimbursement of alirocumab or evolocumab as per national insurance policy), clinical and demographic predictors of Lp(a) levels reduction after 12 weeks of PCSK9 antibody therapy were assessed. Results We included 518 patients (average age 58 years, 21% females): 84 (16.2%) had Lp(a) levels >100 mg/dL and 137 (26.4%) had Lp(a) levels >50 mg/dL. Only the female sex was independently associated with increased Lp(a) levels >100 mg/dL and >50 mg/dL (32.1%, p=0.008 and 27.7%, p=0.030, respectively). In 57 patients on PCSK9 antibody therapy based on Lp(a) >100 mg/dL, cigarette smoking and body mass index (BMI) were independent baseline-adjusted predictors of Lp(a) reduction after 3 months of PCSK9 antibody therapy; non-smokers had 27.5 mg/dL greater decrease in Lp(a) as compared to smokers (p=0.004), and BMI was associated with a decrease of 2.6 mg/dL per unit of BMI (p=0.020), respectively. ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1093/eurheartj/ehad655.2499 |
| Availability: |
https://doi.org/10.1093/eurheartj/ehad655.2499; https://academic.oup.com/eurheartj/article-pdf/44/Supplement_2/ehad655.2499/53604825/ehad655.2499.pdf |
| Rights: |
https://academic.oup.com/pages/standard-publication-reuse-rights |
| Accession Number: |
edsbas.C642B079 |
| Database: |
BASE |