New Hope for Preventing Recurrent Coronary Heart Disease: Targeting Lp(a) Protein

2023-06-23 16:37:00

Al Arabiya.net – Jamal Nazi

Posted on: June 23, 2023: 08:37 PM GST Last updated: June 23, 2023: 09:05 PM GST

After the harmful genetic cholesterol protein was identified as a hidden problem in coronary heart disease (CHD), the effect of current drugs targeting LDL-low-density lipoproteins was found to be very small, which called for new research.

In an observational study of 607 adults aged 60 and over over 16 years, Lp(a) levels were higher and more prevalent in those who had recurring coronary artery disease.

These results highlight the link, and highlight the need for targeted therapies specifically for Lp(a), according to the New Atlas website, citing the journal Current Medical Research & Opinion.

In turn, lead researcher Leon Simmons, associate professor at the University of New South Wales College of Clinical Medicine in Sydney, explained that the results of the study indicate the growing evidence of a relationship between increased Lp (a) and the risk of recurrent coronary heart disease, as it is well established that people who People who have already had CHD are at very high risk of it coming back.

He added that the new findings suggest that new therapies under development aimed at reducing elevated Lp(a) might help prevent recurrence of coronary heart disease.

Heart health

He also went on to say that lipoproteins, which also include high-density lipoprotein HDL, are the mechanisms by which cholesterol moves through the bloodstream. HDL is generally considered beneficial, because it takes cholesterol to the liver, where it can be removed from the body.

Heart attacks and strokes

LDL cholesterol, on the other hand, is responsible for the buildup of cholesterol on artery walls. Lp(a) protein, also present in human plasma, is synthesized from LDL and a large hydrophilic glycoprotein called lipoprotein, called apoprotein a.

It contains structural elements of lipoproteins and blood clotting systems associated with premature coronary artery disease and stroke, which previous research has highlighted in heart attacks and strokes.

While Lp(a) levels are 75-95% inheritable, it is estimated that one in five people is born with the genetic coding for it.

Also, Lp(a) levels cannot be ascertained during a common blood test for cholesterol. One positive aspect is that frequent tests are not needed to check Lp(a) levels, since it is genetic, so levels remain stable throughout life.

Lp(a) is particularly insidious, the Australian researchers explain, as high levels are unlikely to present with any noticeable physical symptoms, and for some, the first clue to elevated levels might be an increased risk of a heart attack.

The study revealed that adults with previous coronary artery disease and elevated Lp(a) levels greater than 355 mg/L had a 53% increased risk of recurrent heart attacks, when compared to people with lower Lp(a) levels. They had a lower limit (ie, less than 50 mg/L) during a 16-year period.

Lp(a) levels may not yet be a target for medical intervention, but the risk can be mitigated with diet and exercise, which is recommended for anyone with all “bad” cholesterol readings. Researchers hope that understanding the role Lp(a) plays in cardiovascular disease will lead to medical intervention that can better target it.

New hope

It is noteworthy that studies have indicated that while current drugs, such as statins, are often prescribed to lower “bad” cholesterol in patients at risk of cardiovascular disease, they do not have any significant or proven effect on the rise in lipoprotein levels. Lp(a)”.

This comes amid hopes for solutions in the future, as some new therapies designed to lower Lp(a) levels are currently in advanced stages of clinical development.

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