I would like to see if anyone on RG has done some detailed studies of the Lp(a)-P or even have broad experience. When I see this elevated in someone with a nomal LDL (50-60) there becomes some challenge to management.
EXAMPLE: LDL 55, HDL 89, TG 120, yet Lp(a)-P 270 (nmol/L)
Dear@Allen
Are you talking about LDL particle size or Lipoprotein (a)?
LDL is normal - at goal. But blood work shows the Lp(a) to be very high. Sikandar Hayat Khan I would have expected that with control of the LDL the Lp(a) would have been similar - and with it being very significantly elevated I was hoping to gather more treatment strategies.
So we are discussing Lp(a) here, we will discuss that.
LDL 55, HDL 89, TG 120, yet Lp(a)-P 270 (nmol/L) [This patient has high HDL than LDL]........R u sure?
The concept of Lp(a) emerged somewhere in 90s and though true its a specific protein -lipid structure which over laps between both HDLc and LDLc .
i guess if you just have the technique to measure LDL particle size measure, you should make that as end-point rather than Lp(a) because residual risk (as you are dealing with) is mostly because of small dense LDL particles.
Lastly American Heart Association guidelines after acknowledging issues pertaining to residual risk still give treatment goals. In this case i guess you should measure particle sizes and if they are like OK you must give your patient some reassurance with continuity of same medicine and lifestyle and monitoring.
He has even achieved secondary target goals for LDL cholesterol concentration of 50 mg/dl.
Regards
yes, and that is very common in patients I treat. Good cardiac exercise, some dietary changes, sometimes 1 of 3 of the statin meds that I use. HDL higher than LDL takes time and dedication - but a very common pattern. the Lp(a) has me confused as it is so very high in the same patient! Sikandar Hayat Khan
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