{"id":369,"date":"2024-02-17T03:43:17","date_gmt":"2024-02-17T02:43:17","guid":{"rendered":"https:\/\/www.institut-athos.at\/?page_id=369"},"modified":"2024-03-26T23:50:06","modified_gmt":"2024-03-26T22:50:06","slug":"info-aktuell","status":"publish","type":"page","link":"https:\/\/www.institut-athos.at\/en\/info-aktuell\/","title":{"rendered":"Current News"},"content":{"rendered":"\n
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Lipoprotein (a) is a low-density lipoprotein (LDL) structure-like lipoprotein.<\/p>\n\n\n\n

Its height is inherited, does not change significantly the whole life and can not be influenced by diet or medicaments.<\/p>\n\n\n\n

A one-time determination is therefore sufficient.<\/p>\n\n\n\n

If the lipoprotein (a) is increased to more than 100 mg \/ dl, life expectancy is shortened by about 10 years. Therapy of choice is on the one hand a particularly pronounced one LDL reduction or – in individual cases – LDL apheresis.<\/p>\n<\/div>\n\n\n\n

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Lp-Apheresis or. PCSK9 \u2013 Inhibitors<\/h4>\n\n\n\n

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The therapy of fat metabolism is always a step therapy.
Firstly, an assessment of nutritional and lifestyle habits as well as a consultation on necessary changes is appropriate. If these measures are not sufficient, a therapy is started with lipid-lowering medications (usually from the family of statins). If this is not sufficient too, a combination with other lipid nuclei can lead to a further improvement in the blood fat values.
If the drug combination therapy is not sufficient or if these side effects occur, a PCSK9 inhibitor therapy is indicated.<\/p>\n\n\n\n

Therapy with PCSK9-Inhibitors<\/strong><\/strong><\/h5><\/td><\/tr>
\u2022 monoclonal antibodies against PCSK9\u00a0(Evolocumab, Alirocumab)
\u2022 each subcutaneously <\/code><\/td><\/tr>
Metabolic Control<\/strong><\/strong><\/h5><\/td><\/tr>
\u2022 under a lipid-lowering therapy (usually statins) together with PCSK9 inhibitors an approx. 50-60% additional reduction of LDL-C is achieved
\u2022 Reduction of the lipoprotein (a) (Lp [a]) by approx. 25%
\u2022 Reduction of triglycerides by 12-17%<\/td><\/tr>
Reduction of cardiovascular events<\/strong><\/strong><\/h5><\/td><\/tr>
\u2022 First results (post-hoc analyzes for evolocumab and alirocumab) show an approx. 50% reduction in cardiovascular events.
\u2022 Final evaluation possible only after publication of the large clinical endpoint studies (expected in 2017).<\/td><\/tr>
Side effects<\/strong><\/strong><\/h5><\/td><\/tr>
\u2022 with the exception of muscle complaints, are not significantly different from the control groups
\u2022 local reaction at the injection site (up to 6% of the affected population)
\u2022 Upper respiratory infections (up to 5%)
\u2022 flu-like symptoms (up to 3%)
\u2022 muscle complaints (up to 5 %)<\/td><\/tr><\/tbody><\/table>
Modified from J f Kardiologie 2016; 23 (1-2), 30-34 \u201eClinical Shortcuts: PCSK9-Hemmer\u201c<\/figcaption><\/figure>\n\n\n\n
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Lp-Apheresis Therapie<\/strong><\/strong><\/h4>\n\n\n\n

However, if the lipoprotein (a) is elevated above the corresponding limit of 100 mg \/ dl, either isolated or in combination with the increase in other blood fats, only liporprotein apheresis is a measure assured by studies.<\/p>\n\n\n\n

Primary prevention<\/strong><\/strong><\/strong><\/h5><\/td><\/tr>
\u2022 Homozygote FH (Start of treatment in childhood)
\u2022 Heterozygote FH,\u00a0despite maximum drug combination therapy LDL-C > 190 mg\/dl <\/code><\/td><\/tr>
Cardiovascular (first) event – secondary prevention<\/strong><\/strong><\/strong><\/h5><\/td><\/tr>
\u2022 Lp(a) > 100 mg\/dl (>~ 250 nmol\/L), At first, LDL-C should be reduced by LDL-C <70mg \/ dL by means of drug combination therapy, if necessary, additional PCSK9 inhibitors. In case of therapy failure, LP-apheresis.
\u2022 In the case of progressive atherosclerosis, LDL-C <70 mg \/ dl and \/ or non-HDL-C <100 mg \/ dl and \/ or non-HDL-Lp <130 mg \/ dl and \/ or increased Lp(a) > 100 mg\/dl (>~ 250 nmol\/L)
\u2022 Documented intolerance of all available statins, LDL-C treatment target is not achieved and Lp (a)\u00a0> 100mg\/dl (>~ 250 nmol\/L)<\/td><\/tr><\/tbody><\/table>
Modified from J f Kardiologie 2016, im Druck<\/em><\/figcaption><\/figure>\n","protected":false},"excerpt":{"rendered":"

Lipoprotein (a) is a low-density lipoprotein (LDL) structure-like lipoprotein. Its height is inherited, does not change significantly the whole life<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-369","page","type-page","status-publish","hentry"],"translation":{"provider":"WPGlobus","version":"2.12.2","language":"en","enabled_languages":["de","en"],"languages":{"de":{"title":true,"content":true,"excerpt":false},"en":{"title":true,"content":true,"excerpt":false}}},"_links":{"self":[{"href":"https:\/\/www.institut-athos.at\/en\/wp-json\/wp\/v2\/pages\/369","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.institut-athos.at\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.institut-athos.at\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.institut-athos.at\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.institut-athos.at\/en\/wp-json\/wp\/v2\/comments?post=369"}],"version-history":[{"count":39,"href":"https:\/\/www.institut-athos.at\/en\/wp-json\/wp\/v2\/pages\/369\/revisions"}],"predecessor-version":[{"id":806,"href":"https:\/\/www.institut-athos.at\/en\/wp-json\/wp\/v2\/pages\/369\/revisions\/806"}],"wp:attachment":[{"href":"https:\/\/www.institut-athos.at\/en\/wp-json\/wp\/v2\/media?parent=369"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}