Safety of low lipoprotein(a) levels: the FOURIER trial - PubMed

5 hours ago

Lipoprotein(a) (Lp(a)) is a causal risk factor for atherosclerosis, but lower levels may raise safety concerns, including diabetes mellitus.
In the FOURIER trial involving 25,090 ASCVD patients, no link was found between Lp(a) levels and hemorrhagic stroke, serious bleeding, neurocognitive events, malignancy, or atrial fibrillation.
Lower baseline Lp(a) levels were inversely associated with both prevalent and incident diabetes mellitus, with no increased risk from evolocumab treatment regardless of Lp(a) levels.
Evolocumab did not increase diabetes risk even in patients with high baseline Lp(a), despite reducing Lp(a) by a median of 71 nmol/L.
Low Lp(a) concentrations were generally safe for most adverse outcomes but were associated with a higher risk of diabetes in patients with atherosclerotic cardiovascular disease.

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