Lipoproteina Linked to Heart Attacks
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June 9, 2009 Genetic testing confirms that high levels of a type of cholesterol known as lipoprotein(a) are associated with an increased risk for heart attacks, but the clinical implications of the finding are unclear.
Lipoprotein(a) has long been suspected of contributing to cardiovascular risk. But this new research offers the strongest evidence yet identifying it as an independent risk factor for heart attack.
The study appears in the June 10 issue of the Journal of the American Medical Association.
LDL, HDL, and Lp(a)
Like low density lipoprotein (LDL), lipoprotein(a) levels can be determined with a simple blood test.
But unlike LDL or high density lipoprotein (HDL), lipoprotein(a) is not routinely measured because it has not been clear if doing so provides additional information about who should be taking cholesterol lowering drugs.
Lipoprotein(a), also known as Lp(a), consists of LDL cholesterol bound to the protein apolipoprotein(a).
Some people are genetically predisposed to have a lot of lipoprotein(a) and others very little. Because of this, Lp(a) levels can vary greatly from person to person.
This wide genetic variability made lipoprotein(a) an ideal candidate for a new type of research that may offer an alternative to long and expensive randomized trials for identifying risk factors for disease.
Instead of lowering lipoprotein(a) levels with drugs, the researchers assessed genetic variations in the gene that controls Lp(a) levels in the blood of close to 45,000 participants in three large long term, follow up studies conducted in Denmark.
They found that heart attack soccer shoes for girls risk increased as lipoprotein(a) levels rose, based upon the underlying genetic code. The association soccer shoes for girls was seen in all three studies.
However, a cardiologist with the NIH’s National Heart Lung and Blood Institute tells WebMD that the new study does little to define how to use Lp(a) measurements.
“It is not clear that this test tells us anything about risk that we don’t already learn from evaluating more established risk factors, says Christopher O’Donnell, MD, MPH. “At present, it can’t really be used for evaluating treatment decisions,But it is not known if lowering Lp(a) with prescription niacin protects against heart attacks, and troubling side effects such as soccer shoes for girls skin itching and flushing similar to hot flashes can occur in people who take the drug.
In an editorial published with the study, O’Donnell and colleague George Thanassoulis, MD, write that the clinical implications of the new research “remain adidas world cup boots quite limited,
“As a cardiologist, I still look for the traditional risk factors which have been shown to be associated with cardiovascular risk, such as LDL, HDL, blood pressure, and other risk factors obtained through diabetes testing and family history, O’Donnell tells WebMD. “I don’t think the evidence from this study would support putting Lp(a) on that list, soccer shoes for girls adidas world cup boots.