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Lp(a) - My Viewpoint

Dr. Joseph I. Miller, MD discusses Lp(a) Basics, Emerging therapies and Guidelines at Napa Cardiology Conference. Learn more at Piedmont.org/heartlearning

Пікірлер: 51

  • @violetg7315
    @violetg731515 күн бұрын

    Our beautiful 36 year old Pharmacist niece died from the major coronary artery 85% blocked last October. Her mother found out from autopsy and had whole family checked Lp(a). The husband and son both have high Lp(a)values. My father in law has many atherosclerosis, cardiovascular disease including all three heart muscle arteries clots and arrhythmia. He is 93 and has been in an out of hospital and on tons meds for decades. His family history has strong cardiovascular disease history. I am talking to my husband and children to have the Lp(a) test soon. I heard it is around $100 without insurance.

  • @davidzip8841
    @davidzip88416 ай бұрын

    Everyone should have their Lp(a) tested once. As a primary patient with no other obvious risk factors, I was surprised that my ApoB was 120. My primary was not even sure I needed a statin because my LDL-C (tested three months later) was 107. Fortunately, I tested my Lp(a) which was 280 nmol. The statin dropped my LDL-C to 79 and ApoB to 80. Without the Lp(a) I would’ve been satisfied. But with this knowledge, I started a PCSK-9 inhibitor.

  • @dwtubeyou

    @dwtubeyou

    6 ай бұрын

    Which PCKS9i did you start with? Did insurance approve paying for it?

  • @davidzip8841

    @davidzip8841

    5 ай бұрын

    @@dwtubeyou repatha. Insurance did cover, but I would have gone forward without insurance.

  • @dwtubeyou

    @dwtubeyou

    5 ай бұрын

    Cool and good luck with the results!

  • @adithyavikram7

    @adithyavikram7

    5 ай бұрын

    Role of diet on LP[a].

  • @JMK-vo8pv

    @JMK-vo8pv

    4 ай бұрын

    I keep reading that MANY lipidologists opine that a person's Lp(a) is very static during one's lifetime. Researcher, Siobhan Huggins, has shown that Lp(a) is far from static and that DIET AND LIFESTYLE can cause very large fluctuations in that lipoprotein's blood level.📈🩸📉 @@adithyavikram7

  • @numberthree267
    @numberthree2675 ай бұрын

    My Lp(a) is 315 nmol. Supposedly this is a genetic inheritance. Yet my parents lived into their 90s with no CVD and I (age 78) have had no symptoms of CVD or aortic stenosis. Clearly, there must be protective factors that mitigate the risks of elevated LP(a). As a scientist, it is obvious to me that our understanding of the role of this lipid in disease is still in its infancy.

  • @WhereNerdyisCool

    @WhereNerdyisCool

    5 ай бұрын

    I'm a little higher than you in Lp(a) but in my low 50's. My PCP recently tested for Lp(a) and it is genetic, my cholesterol has always been at the normal / tad high LDL (131 or 132). HDL 80, Tg 90. I started Repatha a few weeks ago and LDL is half what it was. Went from Lipitor to Crestor a year prior and happy to leave the achy muscles behind. Like any genetic predisposition, I'm doing what I can control. Low carb diet, 4-5 days pf cardio and resistance work, supplements like Lysine, chondroitin sulfate, fish oil and so on.

  • @sandybayes

    @sandybayes

    4 ай бұрын

    I have a much lower LPa of 81 and have had 3 strokes!

  • @sheddkkhan6758

    @sheddkkhan6758

    4 ай бұрын

    Did you go for any test?

  • @sandybayes

    @sandybayes

    4 ай бұрын

    @@sheddkkhan6758 Yes I did in 2012 and it was 81 nmol/L. after I discovered online that it could be a possible cause for my mini strokes. At least the Dr was willing to go along with my request. There wasn't really any treatment though except to be placed on a statin. Have you been tested?

  • @sheddkkhan6758

    @sheddkkhan6758

    4 ай бұрын

    Hi

  • @user-os3mz7ck1i
    @user-os3mz7ck1i5 ай бұрын

    Inflammation as the mechanism is more important than lpa which is the effect not cause. You stated yourself events continued with lowered lpa, reinforcing my point

  • @cynthiaschaeffer650

    @cynthiaschaeffer650

    3 ай бұрын

    Can you please clarify your comment? Everything I have read since finding out I have very elevated Lp(a) has indicated that our Lp(a) measurement is pretty much set for life by age 5, with very little change as we age other than a slight bump for women after menopause, and the Lp(a) number itself is not affected by lifestyle, nutrition, or activity. If that is so, how can Lp(a) be an effect of anything other than genetics?

  • @user-os3mz7ck1i

    @user-os3mz7ck1i

    3 ай бұрын

    A very detailed explanation of the physiology is done by dr. Robert cywes , on his youtube channel in one of his newer videos. The lpa from my understanding can fluctuate but that is not the cause of atherosclerosis and isn’t even an accurate proxy for atherosclerosis anyway. Cardiologists recommend getting a cimt score and cac score to more accurately and directly measure atherosclerosis

  • @_dash--5464

    @_dash--5464

    2 ай бұрын

    Atherosclerosis is caused only by inflammation. Lpa is just an observer. APOB must be measured to know your inflammation. Even CRP doesn't show the inflammation in the arteries. Lpa

  • @polycrystallinecandy

    @polycrystallinecandy

    15 күн бұрын

    A minor decrease doesn't affect the risk much. It needs to be decreased by 70% or more for substantial reduction. On the flip side, it probably means the risk increase is sub-linear with increase in LP(a), which is a silver lining.

  • @Malcolm-Achtman

    @Malcolm-Achtman

    13 күн бұрын

    @@cynthiaschaeffer650 Lp(a) can certainly be influenced by nutrition. It's not all genetics.

  • @Youtubedisco
    @Youtubedisco4 ай бұрын

    My Lipoprotein-a is 31 nmol. I'm a 63-year old female who eats 80 percent animal based. No inflammation.

  • @RHt09

    @RHt09

    4 ай бұрын

    Why are you commenting about your level when you are in the normal range?

  • @Malcolm-Achtman

    @Malcolm-Achtman

    13 күн бұрын

    @@RHt09 I think the comment infers that a largely animal based diet is a viable way to tackle Lp(a). It works better than drugs and is safer too. After going low carb my Lp(a) dropped from 32 mg/dL down to 15 mg/dL. When I went more strictly animal based, my Lp(a) dropped to as low as 10 mg/dL.

  • @richards4422
    @richards44225 ай бұрын

    Do true anticoagulants (not just aspirin) offer any protection since Lp(a) promotes blood clotting?

  • @RHt09

    @RHt09

    4 ай бұрын

    There's some evidence that plavix+aspirin is helpful long-term in people who have had a coronary stent already and also have a high Lp(a). There is no evidence in the general population with high Lp(a) that other anticoagulants have benefit

  • @sandybayes
    @sandybayes4 ай бұрын

    Would blood thinners reduce the chance of stroke for those with elevated LPa?

  • @JMK-vo8pv
    @JMK-vo8pv4 ай бұрын

    If Lp(a) is such a "BAD" lipoprotein, why is it that there are a significant number of elderly humans who have lifelong elevated Lp(a) blood levels, yet their coronary angiograms show pristine coronary arteries-ZERO plaque? Please see Dr. Nadir Ali's KZread presentation on Lp(a).

  • @sheddkkhan6758

    @sheddkkhan6758

    4 ай бұрын

    When dr nadir said it

  • @JMK-vo8pv

    @JMK-vo8pv

    4 ай бұрын

    @@sheddkkhan6758 Please take a look at Dr. Nadir Ali's KZread video on Lp(a) from September 14, 2021. Dr. Nadir Ali believes that Lp(a), just like LDL, is a FIREFIGHTER. Lp(a) and LDL particles are part of the repair proces of arteries that have been inflamed and damaged.

  • @RHt09

    @RHt09

    4 ай бұрын

    If smoking causes lung cancer, why are there a significant number of elderly humans who have smoked their entire lives with no lung cancer?

  • @sheridixon190
    @sheridixon190Ай бұрын

    Mine is

  • @flolou8496
    @flolou84965 ай бұрын

    ??? From a molecular structure perspective, do you know if the cholesterol found in animal based products, like say ground beef, or different types of steak, is the exact chemcial nature and structure produced organically by our internal organs, (namely the liver) I find it very curious that ''cholesterol'' from diet sources, got so much negative attention the past 50 years, while the public remained largely ignorant that 75 to 80% of cholesterol in the body is made organically, but I think we need to be first asking how human liver made cholesterol our body's have been making is potentially different dietary cholesterol from cattle and eggs? (maybe it's time to zoom out and question first the chemical nature of each, than move on to any mechanical differences, rather than just assume ''cholesterol is cholesterol'' (maybe that assumption all along should be re-analyzed) P.S. 10% apx of our brain matter is cholesterol.

  • @HendrikRitsema
    @HendrikRitsema4 ай бұрын

    Best treatment for atherosclerosis: Vitamin C Why do only coronary arteries clog with cholesterol and not veins or small capillaries? Scurvy = No vitamin C in your diet. Symptom: Your blood vessels break and you bleed to death. Think of the sailor of the past. Scurvy of the heart = Just enough vitamin C from food. Symptom: Arteries around the heart are not strong enough to resist high blood pressure. Damage is repaired with cholesterol LP(a) to prevent worse. After years of repair, your arteries become clogged. Enough vitamin C supplement of at least 3000 mg. per day gives strong and flexible arteries. Cholesterol is not needed as a repair agent. Cholesterol in your coronary arteries is broken down and burned in your liver. Source KZread: Cardiovascular disease and vitamin C (Dr. Rath Foundation) or Breakthrough Towards The Natural Control Of Cardiovascular Disease - Dr. Rath's 2018 Cyprus Lecture

  • @Alic3IiWL
    @Alic3IiWL4 ай бұрын

    Terriblely undisciplined chaotic presentation. It a very rough draft that says everything that comes to mind. This guy should have edited this down. There is way too much unnecessary verbiage.

  • @adithyavikram7
    @adithyavikram75 ай бұрын

    Role of diet in lipoprotein a