Categoria dell'articolo: Original Research
Pubblicato online: 26 dic 2024
Pagine: 142 - 150
Ricevuto: 16 set 2024
Accettato: 11 nov 2024
DOI: https://doi.org/10.2478/jce-2024-0022
Parole chiave
© 2024 Anna Pasławska et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.
FIGURE 1.
FIGURE 2.
FIGURE 3.
FIGURE 4.
Lp(a) cut-off values according to different guidelines
| Polish Lipid Association 2021 |
<75 nmol/l – optimal Lp(a) level 75–125 nmol/l – moderate cardiovascular risk >125–450 nmol/l – high cardiovascular risk >450 nmol/l – very high cardiovascular risk |
| HEART UK consensus 2019 |
32–90 nmol/l – low risk of cardiovascular disease 90–200 nmol/l – modest risk 200–400 nmol/l – high risk >400 nmol/l – very high risk |
| European Society of Cardiology/European Atherosclerosis Society 2019 |
<75 nmol/l – optimal Lp(a) level >75 nmol/l – progressive risk >125 nmol/l – significantly increased risk > 430 nmol/l – high risk |
The factors that influence Lp(a) levels2,3,15,16,17
|
Ethnic origin (Black African, African American) Pregnancy (Lp(a) level returns to normal values after delivery) Acute inflammatory states (Lp(a) level normalizes with recovery) Kidney function impairment (from the early stages) Antiviral treatment (hepatitis C) Growth hormone replacement therapy Diet based on unsaturated fats or carbohydrates |
Impaired liver function (hepatocyte damage) Postmenopausal hormone replacement therapy Treatment of overt and subclinical hypothyroidism Diet based on low-carbohydrate and high-saturated fat products Flaxseed and walnuts in the diet |
Pro-atherogenic and prothrombotic mechanisms of Lp(a)4
| ↑ oxidized phospholipids | ↓ plasminogen activation |
| ↑ foam cell formation | ↓ fibrinolysis |
| ↑ endothelial dysfunction | ↓ tissue factor pathway inhibitor |
| ↑ smooth muscle cell proliferation | ↓ clot stability |
| ↑ monocyte chemotaxis | ↑ platelet response |
| ↑ arterial wall inflammation (IL-8, monocyte chemotactic protein, TNF-α) | ↑ plasminogen activator inhibitor-1 (PAI-1) |