Latest in lipidology: is lipoprotein(a) "the most dangerous particle you ’ve never heard of"?

Dr Attia's podcast on Lp(a), the link is here:https://peterattiamd.com/tomdayspring6/Discussed:- ApoB as a preferred metric over LDL-P [16:30]; Atherogenic lipoproteins (apoB/LDL-P) as front and center in pathogenesis of CVD. ApoB and LDL-P are used interchangeably, but this is not quite accurate.- Therapeutic goals for apoB concentration [21:45]-Lipoprotein(a)—the most dangerous particle you’ve never heard of [55:00];preferred lab measurements [1:17:45]; Lipoprotein(a), or Lp(a), is a distinctive particle with 2 components:  - a lipoprotein core that resembles LDL-  a shell that contains apolipoprotein(a), or apo(a)Lp(a) is dubbed one of the final frontiers in lipid management. Elevated blood Lp(a) levels are primarily due togenetic variations in the LPA gene that encodes for apo(a) and cannot be lowered by diet, exercise or current lipid-lowering therapies. “By combining the atherosclerotic effects of LDL with the prothrombotic effects of apo(a), elevated Lp(a) essentially delivers adouble whammy of noxious atherothrombotic effects", as per Dr Nissen. Normal Lp(a) levels are less than 25 mg/dL, with significant risk of atherothrombotic events beginning at levels 50-70 mg/dL and rising thereafter. And that risk is not at all rare: 64 million U.S. residents have an Lp(a) level of 60 mg/dL or higher. Over 3 million have levels of 180 mg/dL or more, which confer extremely high risks. There are no effective Lp(a)-lowering pharmacotherapies to ...
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