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0:00
Hello there. My name
is Jaimini Cegla.
I'm a consultant in
Metabolic Medicine at
Imperial College
Healthcare NHS Trust.
I've got a special interest in
lipids and cardiovascular risk.
Today, I'm going to be talking
about lipoprotein(a),
or Lp(a) for short.
0:18
What I hope to cover over
the next 20 minutes or so
is the effect of lipoprotein(a)
concentration on cardiovascular risk,
in whom we should
consider measuring Lp(a),
some of the current and
future treatment options,
and further research avenues
that we have available.
0:37
I'm going to start
off with a case,
and this is someone that I'd
typically might see in my clinic.
This is Mrs. K.
She's a 57-year-old
lady and she's
got a background history
of some fibromyalgia,
and she had a PCI
to her LAD in 2022.
Her medicines are as
much as you would
expect in someone
who's had a PCI,
and she's on atorvastatin
20 milligrams
once a day for cholesterol.
There is a noise in
her family history.
Her father had an MI at 59
and her brother had a PCI at 62.
Her blood pressure is
pretty reasonable;
it could be slightly
more tightly controlled,
her BMI is 24 and
she's a non-smoker.
Looking at her lab tests,
we can see that
her CRP is normal;
her eGFR is normal.
She doesn't have diabetes,
and her lipids are not ideal;
her LDL cholesterol
probably could
be a bit more
tightly controlled.
1:31
That's the standard lipid
profile we would get.
However, in someone
like her who has not
really had any other
obvious risk factors
other than that family history,
in our clinic we would have
tested lipoprotein(a).
In this lady, her Lp(a)
came back at 355
nanomoles per liter.
To put this into context,
when we look at the EAS,
elevated Lp(a) thresholds,
you talk about 125
which equates to
the 83rd percentile of
Lp(a) concentration,
her levels are
exceptionally high.
These are between the 95th
and the 99th percentile.
These really help to
explain why this lady
may have had premature
cardiovascular disease.
