Evaluation of lipoprotein(a) — a novel cardiovascular risk factor in patients with atherosclerotic cardiovascular diseases receiving PCSK9-targeted therapy in Russian real-world practice

Aim. To evaluate the effect of PCSK9-targeted therapy on lipoprotein(a) (Lp(a)) levels in patients with atherosclerotic cardiovascular diseases who have not achieved the target low-density lipoprotein cholesterol (LDL-C) level (statins at maximum tolerated doses and/or ezetimibe).Material and method...

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Main Authors: A. I. Sapina, Yu. Yu. Varlamova, M. G. Papyrina, A. S. Bezymyannyy, E. L. Kordzaya, E. Yu. Vasilyeva
Format: Article
Language:Russian
Published: «FIRMA «SILICEA» LLC 2025-01-01
Series:Российский кардиологический журнал
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Online Access:https://russjcardiol.elpub.ru/jour/article/view/6177
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author A. I. Sapina
Yu. Yu. Varlamova
M. G. Papyrina
A. S. Bezymyannyy
E. L. Kordzaya
E. Yu. Vasilyeva
author_facet A. I. Sapina
Yu. Yu. Varlamova
M. G. Papyrina
A. S. Bezymyannyy
E. L. Kordzaya
E. Yu. Vasilyeva
author_sort A. I. Sapina
collection DOAJ
description Aim. To evaluate the effect of PCSK9-targeted therapy on lipoprotein(a) (Lp(a)) levels in patients with atherosclerotic cardiovascular diseases who have not achieved the target low-density lipoprotein cholesterol (LDL-C) level (statins at maximum tolerated doses and/or ezetimibe).Material and methods. The study involved 3 Moscow medical facilities of the state healthcare system. The study included 50 people who received inclisiran therapy, 30 people — PCSK9 inhibitors (alirocumab, n=1; evolocumab, n=29). This analysis presents the results of Lp(a) level changes over 12-month inclisiran therapy. Lp(a) was determined by turbidimetry. Elevated Lp(a) level was defined as ≥50 mg/dL (125 nmol/L).Results. Normal Lp(a) levels were determined in 16 subjects (34,8%), moderate — in 9 subjects (19,6%), high — in 21 subjects (45,7%), and extremely high (>180 mg/dL) — in 8 subjects (17,4%). Inclisiran therapy was associated with a significant (p<0,001) decrease in both LDL-C and Lp(a) levels by 52% and 54,7%, respectively. During therapy, normal Lp(a) levels remained within baseline values. In almost half of the cases with moderate Lp(a) values, its concentration decreased to normal values, and in cases with elevated Lp(a), its level decreased in 9 out of 10 patients. The proportion of patients in the group with Lp(a) levels <30 mg/dl increased from 35% to 41%. No patient had extreme values by the end of the study.Conclusion. Lp(a) assessment may be appropriate with ongoing PSCK9-targeted therapy. Diagnosis of hyper-Lp(a) is important for early intensive combination lipid-lowering therapy and modification of risk factors in order to reduce the risk of cardiovascular diseases.
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spelling doaj-art-a1f3c8f91b8d4c75bfc389c84ec4bc3b2025-08-04T13:00:34Zrus«FIRMA «SILICEA» LLCРоссийский кардиологический журнал1560-40712618-76202025-01-01291210.15829/1560-4071-2024-61774287Evaluation of lipoprotein(a) — a novel cardiovascular risk factor in patients with atherosclerotic cardiovascular diseases receiving PCSK9-targeted therapy in Russian real-world practiceA. I. Sapina0Yu. Yu. Varlamova1M. G. Papyrina2A. S. Bezymyannyy3E. L. Kordzaya4E. Yu. Vasilyeva5I.V. Davydovsky City Clinical Hospital; Research Institute for Healthcare and Medical Management of the Department of Health of the city of MoscowDiagnostic and Clinical Center № 1City Clinic № 46Directorate for coordination of activities of medical organizations of the Department of Health of the city of MoscowI.V. Davydovsky City Clinical HospitalI.V. Davydovsky City Clinical Hospital; Russian University of MedicineAim. To evaluate the effect of PCSK9-targeted therapy on lipoprotein(a) (Lp(a)) levels in patients with atherosclerotic cardiovascular diseases who have not achieved the target low-density lipoprotein cholesterol (LDL-C) level (statins at maximum tolerated doses and/or ezetimibe).Material and methods. The study involved 3 Moscow medical facilities of the state healthcare system. The study included 50 people who received inclisiran therapy, 30 people — PCSK9 inhibitors (alirocumab, n=1; evolocumab, n=29). This analysis presents the results of Lp(a) level changes over 12-month inclisiran therapy. Lp(a) was determined by turbidimetry. Elevated Lp(a) level was defined as ≥50 mg/dL (125 nmol/L).Results. Normal Lp(a) levels were determined in 16 subjects (34,8%), moderate — in 9 subjects (19,6%), high — in 21 subjects (45,7%), and extremely high (>180 mg/dL) — in 8 subjects (17,4%). Inclisiran therapy was associated with a significant (p<0,001) decrease in both LDL-C and Lp(a) levels by 52% and 54,7%, respectively. During therapy, normal Lp(a) levels remained within baseline values. In almost half of the cases with moderate Lp(a) values, its concentration decreased to normal values, and in cases with elevated Lp(a), its level decreased in 9 out of 10 patients. The proportion of patients in the group with Lp(a) levels <30 mg/dl increased from 35% to 41%. No patient had extreme values by the end of the study.Conclusion. Lp(a) assessment may be appropriate with ongoing PSCK9-targeted therapy. Diagnosis of hyper-Lp(a) is important for early intensive combination lipid-lowering therapy and modification of risk factors in order to reduce the risk of cardiovascular diseases.https://russjcardiol.elpub.ru/jour/article/view/6177lipoprotein(a)atherosclerotic cardiovascular diseasesinclisiran
spellingShingle A. I. Sapina
Yu. Yu. Varlamova
M. G. Papyrina
A. S. Bezymyannyy
E. L. Kordzaya
E. Yu. Vasilyeva
Evaluation of lipoprotein(a) — a novel cardiovascular risk factor in patients with atherosclerotic cardiovascular diseases receiving PCSK9-targeted therapy in Russian real-world practice
Российский кардиологический журнал
lipoprotein(a)
atherosclerotic cardiovascular diseases
inclisiran
title Evaluation of lipoprotein(a) — a novel cardiovascular risk factor in patients with atherosclerotic cardiovascular diseases receiving PCSK9-targeted therapy in Russian real-world practice
title_full Evaluation of lipoprotein(a) — a novel cardiovascular risk factor in patients with atherosclerotic cardiovascular diseases receiving PCSK9-targeted therapy in Russian real-world practice
title_fullStr Evaluation of lipoprotein(a) — a novel cardiovascular risk factor in patients with atherosclerotic cardiovascular diseases receiving PCSK9-targeted therapy in Russian real-world practice
title_full_unstemmed Evaluation of lipoprotein(a) — a novel cardiovascular risk factor in patients with atherosclerotic cardiovascular diseases receiving PCSK9-targeted therapy in Russian real-world practice
title_short Evaluation of lipoprotein(a) — a novel cardiovascular risk factor in patients with atherosclerotic cardiovascular diseases receiving PCSK9-targeted therapy in Russian real-world practice
title_sort evaluation of lipoprotein a a novel cardiovascular risk factor in patients with atherosclerotic cardiovascular diseases receiving pcsk9 targeted therapy in russian real world practice
topic lipoprotein(a)
atherosclerotic cardiovascular diseases
inclisiran
url https://russjcardiol.elpub.ru/jour/article/view/6177
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