Changes in lipoprotein(a) and their association with LDL-C in patients with ACS treated with triple oral lipid-lowering therapy - PubMed
21 hours ago
- #Lipoprotein(a)
- #LDL-C Reduction
- #Acute Coronary Syndrome
- Lipoprotein(a) [Lp(a)] is a genetically determined risk factor for atherosclerotic cardiovascular disease, but its short-term response to aggressive lipid-lowering therapy after acute coronary syndrome (ACS) is unclear.
- The study evaluated 1-month changes in Lp(a) and whether baseline Lp(a) levels are associated with LDL-C goal achievement in statin-naive ACS patients on triple oral lipid-lowering therapy (rosuvastatin, ezetimibe, and bempedoic acid).
- Despite a 59.1% reduction in mean LDL-C after 1 month, average Lp(a) increased by 91%, from 42.2 mg/dL to 80.5 mg/dL (P < .001).
- LDL-C targets of <50 mg/dL and <55 mg/dL were achieved in 68.9% and 78.6% of patients, respectively.
- Baseline Lp(a) independently predicted failure to reach LDL-C goals (adjusted odds ratio 0.97, P < 0.001), while diabetes mellitus increased the likelihood of achieving targets (adjusted odds ratio 2.69, P = .006).
- A strong inverse relationship was found between Lp(a) change and LDL-C goal achievement (ρ = -0.38, P < 10⁻¹²).
- The study concluded that aggressive therapy reduces LDL-C but is accompanied by a substantial rise in Lp(a), likely reflecting an acute-phase response. Baseline Lp(a) may limit LDL-C target attainment, suggesting early Lp(a) testing could improve risk assessment and guide Lp(a)-focused treatments.