A study to reduce the strongest inherited risk factor for heart attack and stroke is now underway at Baylor College of Medicine and other sites across the country and Canada.
Heart specialists at Baylor say the protein lipoprotein(a), known as Lp(a), has been shown to not only be associated with a higher risk of cardiovascular issues but also to be the cause.
“As high levels of Lp(a) travel through the bloodstream, it collects in the arteries, leading to gradual narrowing of the artery that can limit blood supply to parts of the body including the heart and brain,” said Dr. Christi Ballantyne, professor of medicine and chief of the section of cardiology at Baylor. “It can increase the risk of blood clots, heart attack or stroke and affects 2 to 3 percent of the population, which is about 6 to 10 million Americans.”
While there is a simple blood test to check Lp(a) levels, the challenge is that there are no approved treatments that directly target Lp(a).
The current clinical trial is evaluating a potential treatment to reduce plasma Lp(a) levels in patients with hyperlipoproteinemia(a) and established cardiovascular disease. It is a randomized, double-blind, placebo-controlled study, meaning participants and researchers are not aware of who is receiving the treatment. There also will be a placebo group that is not receiving the treatment although five out of six patients randomized will receive the drug at some dose. Baseline levels will be recorded before, during and at determined intervals to compare group results.
“The goal is to test a therapy that targets messenger RNA, which in turn prevents Lp(a) from being produced at such high levels. So it will block the protein from being made,” Ballentyne said.
“It is still important to talk to your doctor about Lp(a) levels. Until a therapy has been approved the most important part of knowing this number, along with your other risk factors, is understanding your overall risk. Your doctor can help you find the right lifestyle modifications or medications to target the other traditional risk factors such as smoking, diabetes, high cholesterol and blood pressure and family history.”
Those risk factors become even more important to monitor when your Lp(a) levels are high, Ballentyne added.
Ballantyne also is the director of the Maria and Alando J. Ballantyne Atherosclerosis Clinical Research Laboratory at Baylor, director of the Center for Cardiovascular Disease Prevention at the Methodist DeBakey Heart Center and co-director of the Lipid Metabolism and Atherosclerosis Clinic at Houston Methodist. He also holds the J.S. Abercrombie Chair in Atherosclerosis and Lipoprotein Research at Baylor.