Lipoprotein(a)

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Lipoprotein(a)
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Overview

Lipoprotein(a) has been called a powerful predictor of premature atherosclerotic vascular disease. As an independent risk factor for premature coronary artery disease, excess Lp(a) concentrations are associated with an increased risk of cardiac death in patients with acute coronary syndromes and with restenosis after angioplasty (PTCA) and coronary bypass procedures. In general, concentrations greater than or equal to 75 nmol/L of Lp(a) in serum are associated with a two- to sixfold increase in risk, depending on the presence of other risk factors.

Lipoprotein(a) has been called a powerful predictor of premature atherosclerotic vascular disease. As an independent risk factor for premature coronary artery disease, excess Lp(a) concentrations are associated with an increased risk of cardiac death in patients with acute coronary syndromes and with restenosis after angioplasty (PTCA) and coronary bypass procedures. In general, concentrations greater than or equal to 75 nmol/L of Lp(a) in serum are associated with a two- to sixfold increase in risk, depending on the presence of other risk factors.

Lp(a) is an independent risk factor for coronary artery disease and cerebral infarction (in white populations) equal to high LDL cholesterol. Serum concentrations are genetically determined. Fifteen percent to 20% of the white population have Lp(a) levels ≥75 nmol/L and are presumed to be at risk. Race-dependent differences in Lp(a) concentrations are known. The significance of high Lp(a) in nonwhite populations must be evaluated with caution. The Lp(a) levels in different ethnic populations can vary widely. Africans, or people of African descent, generally have Lp(a) levels higher than Caucasians and Asians, while Native Americans generally have levels lower than Caucasians. This variability of Lp(a) levels by ethnic population requires careful interpretation of results based on a knowledge of the patient and other cardiac risk factors that may be present.

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