The Importance of Lipoprotein-A and Homocysteine as an Emerging CVD Risk Factors

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Category: CME
Sub-Category: ALTE/LABM
Date: 5/28/2006
Time:9:00 AM to 9:45 AM
Facility: Moscone Convention Center
Location: Gateway Ballroom 103
Description: At the conclusion of this presentation, participants will be able to:
Discuss the clinical importance of lipoprotein-a as a cardiovascular risk factor
Interpret lipoprotein-a results and plan an appropriate course of treatment
Explain the clinical importance of homocysteine as a cardiovascular risk factor
Interpret homocysteine results and plan an appropriate course of treatment

Lipoprotein-a (Lp(a)) and homocysteine are two of the emerging risk factors for cardiovascular disease (CVD) recognized in the National Cholesterol Education Program (NCEP) Adult Treat Panel III guidelines. Lp(a), is a unique lipoprotein that contains a highly variable glycoprotein, apo(a). The apo(a) domain mimics plasminogen but shares none of its “clot buster” activity while the lipoprotein domain is nearly identical to LDL. As a result, Lp(a) is potentially linked with both atherosclerosis and thrombosis. Results of numerous clinical trials seem to offer contradictory data concerning the importance of Lp(a) as an independent risk factor for cardiovascular disease. Part of this may be related to the difficulty measuring Lp(a) as well as a strong ethnic dependency. Most lipid-lowering therapies with the exception of nicotinic acid do not alter Lp(a) levels. Similarly, there is controversy regarding the clinical importance of elevated homocysteine (Hcy) levels. Hcy is an amino acid that appears to be associated with early vascular damage through a variety of different effects but whether it causes the damage or is simply a marker for damage is not clear. Multiple assays have been developed to measure Hcy levels and folic acid supplementation reduces plasma levels in many subjects. The purpose of this presentation is to present a summary of the clinical data linking Lp(a) and Hcy to CVD as well as practical aspect related to testing and treatment.
Speaker(s): Robert C. Scott III, M.D., Ph.D., F.A.C.C. 


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