Recommendations of the Experts of the Polish Cardiac Society (PCS) and the Polish Lipid Association (PoLA) on the diagnosis and management of elevated lipoprotein(a) levels

被引：28

作者：

Sosnowska, Bozena ^{[1
]}

Stepinska, Janina ^{[2
]}

Mitkowski, Przemyslaw ^{[3
]}

Bielecka-Dabrowa, Agata ^{[1
,4
]}

Bobrowska, Beata ^{[5
]}

Budzianowski, Jan ^{[6
,7
]}

Burchardt, Pawel ^{[8
,9
]}

Chlebus, Krzysztof ^{[10
]}

Dobrowolski, Piotr ^{[11
]}

Gasior, Mariusz ^{[12
]}

Jankowski, Piotr ^{[13
]}

Kubica, Jacek ^{[14
]}

Mickiewicz, Agnieszka ^{[15
]}

Mysliwiec, Malgorzata ^{[16
]}

Osadnik, Tadeusz ^{[17
]}

Prejbisz, Aleksander ^{[11
]}

Rajtar-Salwa, Renata ^{[5
]}

Wita, Kristian ^{[18
]}

Witkowski, Adam ^{[19
]}

Gil, Robert ^{[20
]}

Banach, Maciej ^{[1
,4
,21
,22
,23
]}

机构：

[1] Med Univ Lodz MUL, Dept Prevent Cardiol & Lipidol, Lodz, Poland

[2] Natl Inst Cardiol, Warsaw, Poland

[3] Poznan Univ Med Sci, Dept Cardiol 1, Poznan, Poland

[4] Polish Mothers Mem Hosp Res Inst PMMHRI, Dept Cardiol & Adult Congenital Defects, Lodz, Poland

[5] Univ Hosp Krakow, Dept Clin Cardiol & Cardiovasc Intervent, Krakow, Poland

[6] Univ Zielona Gora, Dept Intervent Cardiol & Cardiac Surg, Coll Med, Zielona Gora, Poland

[7] Multidisciplinary Hosp, Nowa Sol, Poland

[8] J Strus Hosp, Dept Cardiol, Poznan, Poland

[9] Poznan Univ Med Sci, Dept Hypertens Angiol & Internal Med, Poznan, Poland

[10] Med Univ Gdansk, Chair & Dept Cardiol 1, Natl Ctr Familial Hypercholesterolem, Gdansk, Poland

[11] Natl Inst Cardiol, Dept Epidemiol Cardiovasc Dis Prevent & Hlth Promo, Warsaw, Poland

[12] Med Univ Silesia, Fac Med Sci Zabrze, Silesian Ctr Heart Dis, Dept Cardiol 3, Zabrze, Poland

[13] Med Ctr Postgrad Educ, Dept Internal Med & Geriatr Cardiol, Warsaw, Poland

[14] Nicolaus Copernicus Univ, Coll Med, Dept Cardiol & Internal Med, Bydgoszcz, Poland

[15] Med Univ Gdansk, Dept Cardiol 1, Lipoprotein Apheresis Lab, Gdansk, Poland

[16] Med Univ Gdansk, Dept Paediat Diabetol & Endocrinol, Gdansk, Poland

[17] Med Univ Silesia, Fac Med Sci Zabrze, Dept Pharmacol, Katowice, Poland

[18] Med Univ Silesia, Sch Med Katowice, Dept Cardiol 1, Katowice, Poland

[19] Natl Inst Cardiol, Dept Intervent Cardiol & Angiol, Warsaw, Poland

[20] Minist Internal Affairs & Adm, Dept Cardiol, Natl Med Inst, Warsaw, Poland

[21] Johns Hopkins Univ, Ciccarone Ctr Prevent Cardiovasc Dis, Div Cardiol, Sch Med,Dept Med, Baltimore, MD USA

[22] Med Univ Lodz, Dept Prevent Cardiol & Lipidol, 281-289 Rzgowska St, PL-93338 Lodz, Poland

[23] Johns Hopkins Univ, Ciccarone Ctr Prevent Cardiovasc Dis, Dept Med, Div Cardiol,Sch Med, 600 N Wolfe St,Carnegie 591, Baltimore, MD 21287 USA

来源：

ARCHIVES OF MEDICAL SCIENCE | 2024年 / 20卷 / 01期

关键词：

cardiovascular disease; lipoprotein(a); management; recommendations; cardiovascular risk; AORTIC-VALVE STENOSIS; OXIDIZED PHOSPHOLIPIDS; CARDIOVASCULAR-DISEASE; SERIES-LIPOPROTEIN; APOLIPOPROTEIN(A) PHENOTYPES; CLINICAL-PRACTICE; NIACIN TREATMENT; LPA GENE; RISK; APHERESIS;

D O I：

10.5114/aoms/183522

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Lipoprotein(a) [Lp(a)] is made up of a low -density lipoprotein (LDL) particle and a specific apolipoprotein(a). The blood concentration of Lp(a) is approximately 90% genetically determined, and the main genetic factor determining Lp(a) levels is the size of the apo(a) isoform, which is determined by the number of KIV2 domain repeats. The size of the apo(a) isoform is inversely proportional to the blood concentration of Lp(a). Lp(a) is a strong and independent cardiovascular risk factor. Elevated Lp(a) levels >= 50 mg/dl (>= 125 nmol/l) are estimated to occur in more than 1.5 billion people worldwide. However, determination of Lp(a) levels is performed far too rarely, including Poland, where, in fact, it is only since the 2021 guidelines of the Polish Lipid Association (PoLA) and five other scientific societies that Lp(a) measurements have begun to be performed. Determination of Lp(a) concentrations is not easy due to, among other things, the different sizes of the apo(a) isoforms; however, the currently available certified tests make it possible to distinguish between people with low and high cardiovascular risk with a high degree of precision. In 2022, the first guidelines for the management of patients with elevated lipoprotein(a) levels were published by the European Atherosclerosis Society (EAS) and the American Heart Association (AHA). The first Polish guidelines are the result of the work of experts from the two scientific societies and their aim is to provide clear, practical recommendations for the determination and management of elevated Lp(a) levels.

引用

页码：8 / 27

页数：20

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