Statins increase Lp(a) value

According to several studies, elevated lipoprotein (a) [Lp(a)] levels are considered a risk factor for cardiovascular diseases. A recent meta-analysis published in Lancet has shown that elevated Lp(a) levels in patients before and during statin therapy are associated with an increased cardiovascular risk; the association is also present when patients exhibit LDL-C levels below 50 mg/dL and/or are at medication for statins or PCSK9 inhibitors.

The meta-analysis of six randomized trials with a total of 5256 individuals (three statin versus placebo patients and three statin versus statin patients) has proved that the Lp(a) value decreases in almost 53 percent of patients on placebo. In the statin group, the mean percentage increase in Lp(a) was 8.5 to 19.6 percent. The outcome of this study supports a recommendation for general separate Lp(a) monitoring in patients with statin therapy. Further studies must clarify the significance of statin induced Lp(a) increase for cardiovascular risk. In addition, the meta-analysis has shown that patients with elevated Lp(a) values benefit less from statins. Monitoring the Lp(a) level appears to be beneficial in any case, as elevated levels are associated with increased cardiovascular risk, even with strong LDL-C reduction by PCSK-9 inhibitors.

Inadequate standardization of available Lp(a) assays has been clearly shown in a number of studies. The use of common reference materials is necessary to reduce differences in values among laboratories and between various measurement systems. The introduction of the internationally recognized WHO/IFCC reference material SRM 2B years ago allows the elimination of essential factors of variability between test systems.

DiaSys implemented the standardization to the WHO/IFCC reference material SRM 2B years ago but decided to continue with standardization in mg/dL in addition to enable a continuation of ongoing studies.

For further information on Lp(a) 21 FS, please refer to the DiaSys website:
https://www.diasys-diagnostics.com/products/reagents/immunoturbidimetry/

References

1. Sotirios Tsimikas et al: Statin therapy increases lipoprotein(a) level; European Heart Journal; DOI: doi.org/10.1093/eurheartj/ehz310

2. Willeit P, Ridker PM, Nestel PJ, Simes J, Tonkin AM, Pedersen TR et al (2018) Baseline and on-statin treatment lipoprotein(a) levels for prediction of cardiovascular events: individual patient-data meta-analysis of statin outcome trials. Lancet 392(10155):1311–1320. doi.org/10.1016/S0140-6736(18)31652-0