One in five people (an estimated 64 million people in the US) has increased levels of small particles in their blood. It can significantly increase the risk of heart attacks and strokes.
But few people knew about it and there was not much to do, so little doctors would have checked it. Dieting is useless. I don’t even exercise. There were no medicines.
But that may change in the near future.
On Sunday, the cardiologist announced that the experimental drug created by Eli Lily of Repodisilan can lower particle levels by 94% with a single injection. The effect lasted for 6 months and there were no serious side effects.
However, it has not yet been confirmed that lowering LP(a) levels reduces the risk of heart attacks and strokes. It awaits a massive clinical trial currently underway.
Lily’s research was presented on Sunday at the American Society of Cardiology’s Annual Meeting and was presented simultaneously Published New England Journal of Medicine. At least four companies are also testing innovative drugs that block the production of the body of LP(A) and the mixing of lipids and proteins.
Dr. David Maron, a preventive cardiologist at Stanford University who is not involved in Lily’s research, said evidence of a severe and long-term reduction in lipoprotein levels by repodisilans is “thrilling.”
Dr. Martha Gulati, a preventive psychologist at Cedars-Sinai Medical Center, was also not involved in the exam, saying the study was “really elegant.”
Eli Lilly is currently conducting large clinical trials asking whether the drug can prevent heart attacks, strokes or cardiovascular death. It will end in 2029. Clinical trials of other drugs targeting LP(a) end more quickly. The first is a study of Novartis drugs that are injected monthly, with results expected in 2026.
However, cardiologists warn that there is no guarantee that medicine will protect people. They remember too well the lessons they learned, assuming that changing risk factors could change risk. Cardiologists were once keen on drugs that raise HDL levels known as “good cholesterol.” People with naturally higher HDL levels had a lower incidence of heart disease. These HDL raming drugs did not help.
Dr. Daniel Rader, a preventive psychologist at the University of Pennsylvania Perelman School of Medicine, says LP(A)-lowering “is a huge new frontier in cardiovascular medicine.” Dr. Radar is a member of Novartis’ Scientific Advisory Committee and has written editorials to accompany new papers.
Treatments targeting LP(a) took a long time.
Lipoprotein was identified as a in 1974 Risk factors for heart disease This is controlled by genes rather than lifestyle or environment.
People with slightly higher than normal LP(a) levels have an approximately 25% increase in their risk of heart attacks and stroke. And very high levels can double the risk, as seen in 10% of the population.
Cardiologists say patients with no obvious reason for heart attacks or stroke (with normal cholesterol levels and blood pressure and not smoking) often know that their LP levels are high. Usually, it is found that they have a family history of heart disease of unknown cause.
The same applies to people who are experiencing heart attacks at a young age, says Dr. Stephen Nissen, a preventive psychologist at Cleveland Clinic, is an academic leader in the Lilly drug trials, and for clinical trials of three other new drugs.
“If you go to the coronary care unit and see a 40-year-old with an acute myocardial infarction, you need to know your LP(a) level,” he said, referring to a heart attack. Often they said their levels were 250 nanomoles or even higher per liter. The normal limit is 75.
Dr. Maron said his clinic is full of people who don’t know why they developed heart disease until they learn that they have high levels of LP.
One is Montewood, a 71-year-old retired firefighter who lives in Reading, California. His LDL cholesterol levels rose to moderately. His blood pressure was normal. He didn’t smoke. However, he had his first heart attack in 2006 while taking cholesterol-lowering statins.
It appeared that almost all of Mr. Kisae’s family had died of heart disease.
His paternal grandmother had her first heart attack when she was in her 40s. She died of a heart attack at the age of 63. His father and his father’s brother died of heart disease. Mr. Kisae’s brother died of a heart attack.
When Dr. Maron tested Wood’s LP level, it was above 400.
Dr. Maron and other preventive psychologists say they regularly test LP(a) levels in all patients, like Dr. Grati, Dr. Nissen and Dr. Radar. Because LP(a) levels are gene-controlled, patients should only test once.
Dr. Nissen is dull with LP(a) patients.
“We say: You have a disability that has serious meaning. I want to take all the risk factors you’ve been off the table,” he said.
But Dr. Grati said that a study found it. 0.3% The US population is receiving insurance-paid LP(a) tests, with only 3% of heart disease patients being tested.
She and other preventive cardiologists say that all adults should take the LP(a) test. If the level is high, your doctor should actively treat all other risk factors.
For Kisei, it meant taking Repatha, a powerful cholesterol-lowering drug that lowered his LDL cholesterol levels to 30.
However, Mr. Kisae’s case did not end there. Dr. Maron led one of the new drugs that lower LP(a) levels to clinical trial testing.
During the exam, Kisae had no symptoms of heart disease. I had no chest pain or shortness of breath. When the exam was finished, his symptoms returned, leading to a square bypass operation.
“It’s anecdotal,” Dr. Maron said. “But these drugs can prevent heart attacks.”
Source: www.nytimes.com
