#97

Took aspirin, niacin etc for which there is low grade evidence for lowering Lpa but made no difference. I dont qualify for a PCSK9i until I have a CV ‘event’ (MI or stroke) as only secondary prevention in the UK.
My CAC last week came back at 31 so not too bad for calcified plaque so far :crossed_fingers:t2:

#98

It seems that SGLT2/1 inhibitors reduce Lpa. Has anyone tested this before and after starting a flozin?

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#99

That’s a really good point. I think Attia brought it to “widespread” attention, at least in our enthusiast demographic. Then you look back at the literature, and people have been saying this for 10 years!

Is that mg/dl? Mine was red flagged at 65 mg/dl, since the target is less than 30.

Sad to say, but the UK NHS is simply not equipped enough to handle the sort of preventative medicine that you’re trying to do. I do everything “out of system” now - private prescriptions, self-paid medications etc. It’s completely pathetic that they’ll wait for you to have a heart attack before they’ll agree to try and prevent you from having a heart attack…

They’ll tell you things are “normal”, but the “normal” guy in the UK dies at 78, and their last decade is spent in very poor health. No thanks.

And the CAC score of 31 is either decent, or very bad, depending on your age and other risk factors.

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#100

I should have included that, whoops. Here is the scale we use

Lipoprotein (a)

nmol/L

134High

Reference Range <75 Risk: Optimal <75 Moderate 75-125 High >125

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#101

Yes, nmol/L as in the UK.

My CAC at 31 was for a 60yr old male.

With my FH of ASCVD (all men either dead or needing CABGs in 50’s) I was expecting a CAC of >100

#102

You should contact Helina Kassuhn (medical director, nice lady) at Amgen. Their new drug drops LPa like a prom dress.
The drug is Olpasirin and is in final testing. Maybe you could get “compassionate use”.
Good luck!

3 Likes
#103

Looks interesting!

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#104

I just got my CardioIQ results back:

LDL small - 156 H
Lipoprotein (a) - 191 H

Other results not extraordinary. But, not liking those values.

#105

Time for Bempedoic Acid and Ezetemibe and/or a statin. The first two should drop your LDL to under 100.

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#106

Gotcha. Then yeah, not terrible, but you hopefully have 30+ years remaining, so you’d definitely want to stop it getting worse.

Thanks a lot for the tip. It will be great when that hits the market. Since I’m young (38) and have ApoB well under control, I’ll wait until the proper data comes out.

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#107

I didn’t check mine until my 19 yr old 98lb super healthy/active daughter got a blood test with 196 LDL and a 96 nmol LPa. I checked mine and it was 53. My total cholesterol is only 135. I started taking Niacinamide 500mg in the morning and 500mg Niacin at night. Dropped LPa by 10. I was told there was no way to lower it so only test one time…BS. I am Ok but I am waiting to get my daughter to test Olpasirin. They did not let her start as she had not had a heart attack or other major problem. I just don’t want her to have a stoke at age 28.

#108

I’ll be discussing that with my lipidologist at my appt. next month. After looking at my elevated LDL he prescribed rosuvastatin 5mg. I have been on the rosuvastatin for a month before the CardioIQ was done. The med did drop the LDL from 113 to 72.
I’m experiencing pronounced fatigue not felt before. Could that be a side-effect of even this small a dose of the med?

#109

Low dose Rosuvastatin caused immense fatigue and muscle soreness for me. I felt 20 years older. It was horrible.

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#110

for me, Atorvastatin had an immediate effect on muscle aches. I switched to Rosuvastatin, and thought I was good but over time (7-8 months) my muscle power dropped off (muscle aches were minimal). I thought i was just getting old but stopping statins all together resolved it. On Bempadoic Acid / Ezetimibe now. No issues so far. Lp(a) was very low all along (<8.4).

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#111

Thanks for sharing

Anyone look at the ones in bold here

Other therapies lower lipoprotein(a) …. include the CETP (cholesteryl ester transfer protein) inhibitor anacetrapib, antibody-based inhibitors of PCSK9 (proprotein convertase subtilisin kexin type 9), and drugs, such as mipomersen and lomitapide, that directly affect the hepatic secretion of apoB-containing lipoproteins.

@lsutiger @Davin8r

#112

Where did they find this - can you share more info?

#113

Does that actually lower Lp(a) or it may lower the risks of having Lp(a) (without affecting the Lp(a) levels)?

#114

I just got my blood work back a couple of days ago. My LPa went up from 148 to 150, so the baby aspirin made no difference. I was under the impression that it should have gone down, but perhaps it just reduced the risk of Mace in spite of elevated LPa. Maybe. We hope. I visit the cardiologist again on April 1st. No joke.

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#115

There is some published data that aspirin can very slightly lower Lp(a), but not enough to make a difference in itself. The anti-platelet effect is what’s supposed to help lower risk of coronary events in those with high Lp(a). I can’t handle aspirin, so I’m on clopidogrel and hoping that I’m getting the same if not better protection I’d get from aspirin :crossed_fingers:

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#116

Wow yeah, that’s similar to my family. I found my sky high LDL-C (200+) through a random blood test. Then we learned my mother also had it, and her brothers all died years ago from heart attacks.

But there are plenty of cases out there of familiar hypercholesterolemia patients having strokes and heart attacks in their 30’s. So it’s absolutely correct that your daughter needs to bring down both LDL-C and the Lp(a). If she can sort them out at 19, she should be absolutely fine. In fact, she may end up better off than “normal”

Maybe. Around 3-5% of patients can’t tolerate statins. For me, I have zero negative effects, and Rosuvastatin even cleared up my fatty liver. Luckily there are plenty of other options nowadays.

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