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Nasljedno stanje koje značajno povećava rizik nastanka kardiovaskularnih bolesti

Viši nivoi Lp(a) povezani su s većim rizikom aterosklerotskih kardiovaskularnih događaja (npr. infarkt miokarda, moždani udar) i aortne stenoze, neovisno o LDL‑kolesterolu.

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Što je Lp(a)?

Lp(a) je čestica slična LDL-kolesterolu, ali s dodatnim apolipoproteinom(a). Njegova koncentracija je uglavnom genski određena i relativno stabilna tijekom života.

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Zašto se testirati na Lp(a)?

Smjernice često preporučuju jednom u životu izmjeriti Lp(a) kod odraslih, posebno ako postoji porodična povijest rane kardiovaskularne bolesti ili neobjašnjivo visok rizik uprkos “normalnom” LDL-kolesterolu.

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Kako se mjeri Lp(a)?

Rutinske kontrole kolesterola predstavljaju odličnu priliku za provedbu testiranja Lp(a). Današnji standard je izražavanje rezultata u nmol/L (molarna koncentracija čestica), jer Lp(a) ima varijabilnu veličinu čestica.

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Život s povišenim Lp(a)

Život s povišenim Lp(a) može biti izazovan jer je nivo uglavnom genetski i ne mijenja se mnogo tokom života. Ipak, mnogo toga možete učiniti da smanjite ukupan kardiovaskularni rizik.

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Lp(a) je nasljedno stanje Zaštitite sebe i svoje najmilije na vrijeme

Shvatite što Lp(a) znači: Viši Lp(a) povećava rizik za aterosklerotske bolesti i aortnu stenozu, neovisno o LDL‑kolesterolu. Cilj je sniziti “ukupan rizik”, čak i ako Lp(a) ostaje povišen.

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Kratice:

  1. LDL, eng. lo w density lipid, lipoprotein niske gustoće
  2. Lp(a), lipoprotein malo „a“
     

Literatura:

  1. Re yes-Soffer G, Ginsberg HN, Berglund L, Duell PB, Heffron SP, Kamstrup PR, et al. American Heart Association Council on Arteriosclerosis, Thrombosis and 
    Vascular Biology; Council on Cardiovascular Radiology and Intervention; and Council on Peripheral Vascular Disease. Lipoprotein(a): A Genetically Determined, 
    Causal, and Prevalent Risk Factor for Atherosclerotic Cardiovascular Disease: A Scientific Statement From the American Heart Association. Arterioscler Thromb 
    Vasc Biol. 2022 Jan;42(1):e48-e60.
  2. Kronenberg F, Mora S, Stroes ESG, Ference BA, Arsenault BJ, Berglund L, et al. Lipoprotein(a) in atherosclerotic cardiovascular disease and aortic stenosis: a 
    European Atherosclerosis Society consensus statement. Eur Heart J. 2022 Oct 14;43(39):3925-3946.
  3. Nordestgaard BG. A Test in Context: Lipid Profile, Fasting Versus Nonfasting. J Am Coll Cardiol. 2017 Sep 26;70(13):1637-1646.
  4. Wilson DP, Jacobson TA, Jones PH, Koschinsky ML, McNeal CJ, Nordestgaard BG, et al. Use of Lipoprotein(a) in clinical practice: A biomarker whose time has 
    come. A scientific statement from the National Lipid Association. J Clin Lipidol. 2019 May-Jun;13(3):374-392.
  5. Pearson GJ, Thanassoulis G, Anderson TJ, Barry AR, Couture P, Dayan N, et al. 2021 Canadian Cardiovascular Society Guidelines for the Management of 
    Dyslipidemia for the Prevention of Cardiovascular Disease in Adults. Can J Cardiol. 2021 Aug;37(8):1129-1150.
  6. Handelsman Y, Jellinger PS, Guerin CK, Bloomgarden ZT, Brinton EA, Budoff MJ, et al. Consensus Statement by the American Association of Clinical 
    Endocrinologists and American College of Endocrinology on the Management of Dyslipidemia and Prevention of Cardiovascular Disease Algorithm - 2020 
    Executive Summary. Endocr Pract. 2020 Oct;26(10):1196-1224.
  7. Grundy SM, Stone NJ, Bailey AL, Beam C, Birtcher KK, Blumenthal RS, Braun LT, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/
    NLA/PCNA Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology/American Heart Association Task Force on 
    Clinical Practice Guidelines. Circulation. 2019 Jun 18;139(25): e1082-e1143.
  8. Kronenberg F. Lipoprotein(a) measurement issues: Are we making a mountain out of a molehill? Atherosclerosis. 2022 May; 349:123-135.
  9. Kamstrup PR. Lipoprotein(a) and Cardiovascular Disease. Clin Chem. 2021 Jan 8;67(1):154-166.
  10. Cegla J, France M, Marcovina SM, Neely RDG. Lp(a): When and how to mesure it? Annals of Clinical Biochemistry 2012;58(1):16-21.
  11. Rogić D. Lp(a) – nedovoljno prepoznat nezavisni čimbenik razvoja ateroskleroze. Pharmabiz 2024;76:32-34.
  12. Cegla J, Neely RDG, France M, Ferns G, Byrne CD, Halcox J, et al. HEART UK Medical, Scientific and Research Committee. HEART UK consensus statement on 
    Lipoprotein(a): A call to action. Atherosclerosis. 2019 Dec; 291:62-70.
  13. Solnica B, Sygitowicz G, Sitkiewicz D, Jóźwiak J, Kasperczyk S, Broncel MS, et al. 2024 Guidelines of the Polish Society of Laboratory Diagnostics and the Polish 
    Lipid Association on laboratory diagnostics of lipid metabolism disorders. Arch Med Sci 2024; 20 (2): 357–374.

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