Elevated lipoprotein(a) and familial hypercholesterolemia in the coronary care unit: Between Scylla and Charybdis

Clinical Cardiology
Katrina L EllisG F Watts

Abstract

Elevated lipoprotein(a) (Lp[a]) and familial hypercholesterolemia (FH) are inherited lipid disorders. Their frequencies, coexistence, and associations with premature coronary artery disease (CAD) in patients admitted to the coronary care unit (CCU) remain to be defined. Elevated Lp(a) and FH are commonly encountered among CCU patients and independently associated with increased premature CAD risk. Plasma Lp(a) concentrations were measured in consecutive patients admitted to the CCU with an acute coronary syndrome (ACS) or prior history of CAD for 6.5 months. Elevated Lp(a) was defined as concentrations ≥0.5 g/L. Patients with LDL-C ≥ 5 mmol/L exhibited phenotypic FH. Premature CAD was diagnosed in those age < 60 years, and the relationship between this and elevated Lp(a) and FH was determined by logistic regression. 316 patients were screened; 163 (51.6%) had premature CAD. Overall, elevated Lp(a) and FH were identified in 27.0% and 11.6% of patients, respectively. Both disorders were detected in 4.4% of individuals. Elevated Lp(a) (32.0% vs 22.2%; P = 0.019) and FH phenotype (15.5% vs 8.0%; P = 0.052) were more common with premature vs nonpremature CAD. Elevated Lp(a) alone conferred a 1.9-fold, FH alone a 3.2-fold, and the co...Continue Reading

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Citations

Mar 7, 2019·Clinical Research in Cardiology Supplements·U JuliusS R Bornstein
Mar 28, 2019·Expert Review of Cardiovascular Therapy·Katrina L EllisGerald F Watts
May 21, 2018·Current Atherosclerosis Reports·Amanda J HooperGerald F Watts
Jan 25, 2019·Nature Reviews. Cardiology·Michael B Boffa, Marlys L Koschinsky
Jul 9, 2020·Journal of Clinical Medicine·Maria Francesca GrecoMassimiliano Ruscica
Aug 3, 2019·Journal of Clinical Lipidology·Chiara PavanelloRosellina Margherita Mancina
Dec 18, 2020·Biochimica Et Biophysica Acta. Molecular and Cell Biology of Lipids·Federico BigazziTiziana Sampietro
Mar 23, 2021·Journal of Atherosclerosis and Thrombosis·Sanjay KalraHung-I Yeh
Aug 29, 2021·Current Atherosclerosis Reports·Amy L PetersonDon P Wilson

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