Chair
Jennifer C Kelley, MD, MSCE
Vanderbilt University Medical Center
Presentations in This Video
Chair
Vinaya -- Simha, MD
Mayo Clinic
The Future Is NOW: Lipoprotein Apheresis Nukes CVD Risk in Elevated Lp(a)
Eliot A Brinton, MD, FAHA, FNLA
Utah Lipid Center
Elevated plasma Lp(a) levels are now an established riskfactor for atherosclerotic cardiovascular disease (ASCVD), independent of LDL-Clevels. Unfortunately, few medications lower Lp(a) levels while they lowerASCVD risk. Potent new Lp(a)-lowering agents are now in late-stage development,and most lipid experts say, incorrectly, that “there are nocurrently approved treatments” for ASCVD prevention by Lp(a) lowering. Surprisingly, lipoprotein apheresis, a powerful butlittle-used lipid treatment, dramatically lowers elevated Lp(a) levels byroughly 60-80% and reduces ASCVD risk by about 80 to 94%! Based on thesedramatic benefits, in 2020 the FDA approved lipoprotein apheresis for CVDprevention in patients with high Lp(a) (roughly double-normal) and a priorASCVD event. Unfortunately, very few cardiologists or lipidologists know thesefacts. Little-known lipoprotein apheresis “nukes” CVD risk in these high-risk patients.While we all eagerly await the eventual approval of new Lp(a) agents, it is harmfulin the meantime to ignore or deny lipoprotein apheresis when indicated.This talk is a call-to-action for all endocrinologists: (1) tomeasure Lp(a) in all patients with ASCVD, and (2) if the Lp(a) level is aboveabout twice the upper-limit of normal, quickly refer that patient to thenearest lipoprotein apheresis center for this life-saving treatment.