Lowering LDL cholesterol levels to offset effects of elevated lipoprotein(a) levels

Canadian Medical Association Journal 1996; 154: 1533-1534
Source: Maher VMG, Brown BG, Marcovina SM et al: Effects of lowering elevated LDL cholesterol on the cardiovascular risk of lipoprotein(a). JAMA 1995; 274: 1771-1774
Post-hoc analysis of results from the Familial Atherosclerosis Treatment Study, in which 146 men with coronary artery disease (CAD) were randomly assigned treatment with lipid-lowering therapy or a placebo, was performed to determine whether lowering elevated low-density lipoprotein (LDL) cholesterol levels could offset the exacerbation of CAD associated with elevated lipoprotein(a) levels. Lipoprotein(a) levels were not significantly altered by lipid-modifying therapy. However, among patients with lipoprotein(a) levels in the 90th percentile or above, the severity of CAD and the rate of cardiovascular events were significantly lower among those whose LDL cholesterol level was reduced by more than 10% than among those whose LDL cholesterol level was reduced by 10% or less. Patients with lipoprotein(a) levels below the 90th percentile showed a similar trend.
CMAJ May 15, 1996 (vol 154, no 10)