Up to one of every five people – an estimated 64 million in the United States – have high levels of a small particle in their blood. It can significantly increase the risk of heart attacks and strokes.
But a few of them know that, and doctors are almost not tested, because there was not much to do. The diet does not help. Not exercising. There were no medications.
But in the near future, this may change.
On Sunday, cardiologists announced that an experimental drug carried out by Eli Lily, Lepodisiran, could reduce particle levels, LP (A), by 94 percent with one injection. The effects lasted for six months and there were no major side effects.
However, it has not yet been emphasized that the reduction of LP (A) levels also reduces the risk of heart attacks and strokes. This is awaiting the large clinical experiences that are now on.
Night research was presented on Sunday at the annual meeting of the American College of Cardiology and at the same time Published In New England Medicine. At least four other companies are testing innovative drugs that prevent the production of the body from LP (A) and a mixture of fat and protein.
Dr. David Maroun, the preventive cardiologist at Stanford, who did not participate in Laila’s research, said the evidence is a deep and long -term decrease in oily protein levels with LePodisiran was “sexy”.
Dr. Martha Golati, a preventive cardiologist at the Cedar City Medical Center, also said the study was “really elegant.”
Elie Lily is now performing a major clinical trial that asks whether his medicine can prevent heart attacks, strokes, or cardiovascular deaths. It will be concluded in 2029. Clinical experiences of other drugs targeting LP (A) will soon be concluded. The first will be a study of Novartis, which was injected monthly, with results expected in 2026.
Heart specialists warn that there is no guarantee that medications will protect people. They remember well a lesson learned from the assumption that changing the risk factor can change the risks. Cardiologists were enthusiastic for drugs that raised HDL levels, known as “good cholesterol”. People with naturally high levels of HDL have lower rates of heart disease. Those drugs that rise HDL Not.
Dr. Daniel Rader, a preventive cardiologist at the University of Pennsylvania Medical College, said that LP (A) -Lowering “new new boundaries in cardiovascular medicine.” Dr. Rader is a member of the Scientific Consulting Council of Novartis and an opening books to accompany the new paper.
The treatments targeting LP (A) were a long time coming.
The sebaceous protein was identified in 1974 as a The risk factor for heart disease It is controlled by genes instead of lifestyle or environment.
People with LP (A) levels are slightly higher than usual they have about 25 percent of the risk of a heart attack or stroke. And very high levels – as shown in 10 percent of the population – can double the risks.
Cardiologists say that in patients who do not have a clear cause of heart injury or stroke – which are cholesterol levels and blood pressure normal and that do not smoke – they learn that patients have high levels of LP (A). It is usually evident that they have a family history of unjustified heart disease.
Dr. Stephen Nissen, a preventive cardiologist at Cleveland Clinic, an academic pioneer to try medicines and clinical trials of three other new drugs for people with heart attacks at an early age.
He said, referring to a heart attack: “If you go to the coronary care unit and see a 40 -year -old with acute myocardial infarction, you need to know the LP (A) level,” referring to a heart attack. He said that its levels often are 250 nanomol per liter or higher. The upper limit is 75.
Dr. Maroun said that his clinic was full of people who had no idea about the reason for their development of heart disease, until they discovered that they had high levels of LP (A).
One of them is Mont Wooden, a 71 -year -old retired firefighter who lives in Reding, California, and the levels of cholesterol in LDL have increased to some extent. It was natural blood pressure. He did not smoke. However, he suffered a heart attack in 2006 while taking a low -cholesterol.
It looked like almost every person in the family of Mr. Wooden died due to heart disease.
His grandmother had a first heart attack when she was in her forties. She died from a heart attack at the age of 63. His father and brother died of heart disease. Mr. Woodin’s brother died from a heart attack.
When Dr. Maroun tested the level of Mr. Wooden LP (A), he was greater than 400.
Dr. Maroun and other preventive cardiologists, such as Dr. Gulati, Dr. Nissen and Dr. Rader, say they are routinely testing all LP (A) levels for their patients. Since LP (A) levels are controlled by genes, they add, patients should be tested only once.
Dr. Nissen is explicit with his patients (A).
“We say: you have a disorder with serious effects. I want to take every risk factor outside the table,” he said.
However, Dr. Gulati said, one study found that only this 0.3 percent Among the residents of the United States, I was conducted a LP (A) test – which is paid by insurance – only 3 percent of people with heart disease were tested.
She and other preventive cardiologists say that all adults should have a LP (A) test. If the levels are high, doctors must treat each other risk factor.
For Mr. Woodin, this meant taking a strong cholesterol, which has received cholesterol in the cholesterol in LDL to 30.
The case of Mr. Woodin, though, did not end there. Dr. Maroun entered him in a clinical trial to test one of the new drugs that reduce LP (A) levels.
During the experiment, Mr. Woodin had no symptoms of heart disease – no chest pain, nor shortness of breath. When the experiment ended, its symptoms returned, which led to a four -way transcendence.
Dr. Maroun said: “It is a stories, but it talks about the possibility that these drugs will prevent heart attacks.”
