Aggressive course of atherosclerosis in hyperlipoproteinemia (a): a case series
A. M. Namitokov,
V. K, Zaphiraki,
E. K. Donets,
O. B. Malyarevskaya,
K. V. Karabakhtsieva,
A. N. Yahutl https://doi.org/10.20996/1819-6446-2023-2873
EDN: NXAEMO
Abstract
Currently, worldwide interest in lipoprotein(a) (LP(a) as one of the most important markers of premature and aggressive atherosclerosis is steadily growing. This trend is due to both the new data on the pathogenesis of hyperlipoproteinemia (a) and the development of novel treatment methods in the near future. The variety of clinical manifestations of atherosclerosis associated with high LP(a) concentrations leads such patients to specialists of various profiles. The aim of this paper was to demonstrate, using examples from the practice of two lipid centers in Krasnodar, the diversity of clinical scenarios of atherosclerosis as a systemic disease in patients with very high LP(a) levels, as well as to highlight the current and future options for the treatment of hyperlipoproteinemia (a).
About the Authors
A. M. Namitokov
Research Institute — Ochapovsky Regional Clinical Hospital № 1;
Kuban State Medical University
Russian Federation
Russian Federation
Alim M. Namitokov
Krasnodar
eLibrary SPIN 6937-744
V. K, Zaphiraki
Kuban State Medical University
Russian Federation
Russian Federation
Vitaly K. Zafiraki
Krasnodar
eLibrary SPIN 9844-3747
E. K. Donets
Research Institute — Ochapovsky Regional Clinical Hospital № 1
Russian Federation
Russian Federation
Ekaterina K. Donets
Krasnodar
O. B. Malyarevskaya
Research Institute — Ochapovsky Regional Clinical Hospital № 1
Russian Federation
Russian Federation
Olga V. Malyarevskaya
Krasnodar
K. V. Karabakhtsieva
Kuban State Medical University
Russian Federation
Russian Federation
Karina V. Karabakhtsieva
Krasnodar
A. N. Yahutl
Adygeya Republic Clinical Hospital
Russian Federation
Russian Federation
Albina N. Yahutl
Krasnodar
eLibrary SPIN 9946-2377
References
1. Berg K. A new serum type system in man--the LP system. Acta Pathol Microbiol Scand. 1963;59:369-382. DOI:10.1111/j.1699-0463.1963.tb01808.x.
2. Kamstrup PR, Tybjaerg-Hansen A, Steffensen R, Nordestgaard BG. Genetically elevated lipoprotein(a) and increased risk of myocardial infarction. JAMA. 2009;301(22):2331-2339. DOI:10.1001/JAMA.2009.801.
3. Zueva IB, Baratashvili GG, Krivonosov DS, Buch AV, Sidorkevich SV. Modern ideas about the role of lipoprotein (a) in the development of cardiovascular events. The possibilities of therapy. Arterial’naja gipertenzija. 2016;22(3):232–243. (In Russ) DOI:10.18705/1607-419X-2016-22-3-232-243.
4. Koschinsky ML. Lipoprotein(a) and atherosclerosis: new perspectives on the mechanism of action of an enigmatic lipoprotein. Curr Atheroscler Rep. 2005;7(5):389-395. DOI:10.1007/s11883-005-0052-y.
5. Koschinsky ML. Novel Insights Into Lp(a) Physiology and Pathogenicity: More Questions Than Answers? Cardiovasc Hematol Disord Drug Targets. 2006;6(4):267-278. DOI:10.2174/187152906779010764.
6. Clarke R, Peden JF, Hopewell JC, et al. Genetic variants associated with Lp(a) lipoprotein level and coronary disease. N Engl J Med. 2009;361(26):2518-28. DOI:10.1056/NEJMoa0902604.
7. Kronenberg F, Mora S, Stroes ESG, et al/ Lipoprotein(a) in atherosclerotic cardiovascular disease and aortic stenosis: a European Atherosclerosis Society consensus statement, Eur Heart J. 2022;43(39):3925-3946. DOI:10.1093/eurheartj/ehac361.
8. Ezhov M. V., Kukharchuk V. V., Sergienko I. V., et al. Disorders of lipid metabolism. Clinical Guidelines 2023. Russian Journal of Cardiology. 2023;28(5):5471. (In Russ.) DOI:10.15829/1560-4071-2023-5471.
9. Diagnostics and correction of lipid metabolism disorders in order to prevent and treat of atherosclerosis. Russian recommendations, VII revision. Journal of atherosclerosis and dyslipidaemias. 2020;1(38):7-42 (in Russ) DOI:10.34687/2219-8202.JAD.2020.01.0002.
10. Mach F, Baigent C, Catapano AL, et al. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J. 2020;41(1):111-188. DOI:10.1093/eurheartj/ehz455
11. Lloyd-Jones D, Morris P, et al. 2022 ACC Expert Consensus Decision Pathway on the Role of Nonstatin Therapies for LDL-Cholesterol Lowering in the Management of Atherosclerotic Cardiovascular Disease Risk. J Am Coll Cardiol. 2022;80(14):1366-1418. DOI:10.1016/j.jacc.2022.07.006
12. Alonso R, Andres E, Mata N, et al. Lipoprotein(a) levels in familial hypercholesterolemia: an important predictor of cardiovascular disease independent of the type of LDL receptor mutation. J Am Coll Cardiol. 2014;63(19):1982-9. DOI:10.1016/j.jacc.2014.01.063.
13. Kraft HG, Lingenhel A, Raal FJ, et al. Lipoprotein(a) in homozygous familial hypercholesterolemia. Arterioscler Thromb Vasc Biol. 2000;20(2):522-8. DOI:10.1161/01.atv.20.2.522.
14. Afanasieva O. I., Ezhov M. V., Pokrovsky S. N. Antisense Oligonucleotides and Therapeutical Monoclonal Antibodies as a Basement for Novel Biological Lipidlowering Drugs Russ J Cardiol. 2018;23(8):99-109 (in Russ) DOI:10.15829/1560-4071-2018-8-99-109
15. Sosnowska B, Surma S, Banach M. Targeted Treatment against Lipoprotein (a): The Coming Breakthrough in Lipid Lowering Therapy. Pharmaceuticals (Basel). 2022;15(12):1573. DOI:10.3390/ph15121573.
16. O’Donoghue ML, Rosenson RS, Gencer B, et al. Small Interfering RNA to Reduce Lipoprotein(a) in Cardiovascular Disease. N Engl J Med. 2022;387(20):1855-1864. DOI:10.1056/NEJMoa2211023.
17. Awad K, Mikhailidis DP, Katsiki N, et al; Lipid and Blood Pressure Meta-Analysis Collaboration (LBPMC) Group. Effect of Ezetimibe Monotherapy on Plasma Lipoprotein(a) Concentrations in Patients with Primary Hypercholesterolemia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Drugs. 2018;78(4):453-462. DOI:10.1007/s40265-018-0870-1.
18. Bittner VA, Szarek M, Aylward PE, et al. Effect of alirocumab on lipoprotein(a) and cardiovascular risk after acute coronary syndrome. J Am Coll Cardiol. 2020;75(2):133-144. DOI:10.1016/j.jacc.2019.10.057.
19. Ray KK, Wright RS, Kallend D, et al. Two Phase 3 Trials of Inclisiran in Patients with Elevated LDL Cholesterol. N Engl J Med. 2020;382(16):1507-1519. DOI:10.1056/NEJMoa1912387.
20. Raal FJ, Kallend D, Ray KK, et al. Inclisiran for the Treatment of Heterozygous Familial Hypercholesterolemia. N Engl J Med. 2020;382(16):1520-1530. DOI:10.1056/NEJMoa1913805.
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For citations:
Namitokov A.M., Zaphiraki V.K., Donets E.K., Malyarevskaya O.B., Karabakhtsieva K.V., Yahutl A.N. Aggressive course of atherosclerosis in hyperlipoproteinemia (a): a case series. Rational Pharmacotherapy in Cardiology. 2023;19(6):591-596. (In Russ.) https://doi.org/10.20996/1819-6446-2023-2873. EDN: NXAEMO
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