Great question, we don't have the data yet, but we may know after Lp(a) HORIZON and other Lp(a) trials if it is measured. I think it may be a more useful marker for clinical risk prediction of higher risk pts and for inclusion of higher risk pts in trials, as it will pick up the

The U.S. FDA accepted our New Drug Application for the treatment of familial chylomicronemia syndrome ( #FCS ) for Priority Review. In addition, enrollment completed in the Ph3 severe hypertriglyceridemia ( #sHTG ) clinical program: ir.ionis.com/news-releases/… $IONS

This is a sad time for medicine with the passing of Dr George Bakris.. even doctors get sick. Both Athena Tsimikas, MD and I knew him well professionally, and he was a tremendous help for us Ionis on our AGT program. I think it can be summarized that he was a gentleman and a

Yes it does, but modestly, average reduction is 15-30%, but new drugs can lower it >80%.

CASABLANCA has provided new and contemporary insights into Lp(a) and OxPL. You guys deserve much credit for forward thinking and excellent organization to create this rich resource.

Maybe the last one, but in 5 serial samples look like there is a trend down. Sometimes what happens is the first value is high due to an unsuspected inflammatory condition, and then it settles back to baseline over 3-6 months.

And for the last treat of the day, Lp(a) and Sam Tsimikas are moving into the heart failure field. Lp(a), likely via its OxPL content, is associated with progression of heart faluure and CVD death. Study led by James Januzzi Jr MD and Pradeep Natarajan There is also data from MESA, more to

It does vary more than it was originally thought. We studieds this carefully in placebo arms of trials with serial blood samples and using the same assay measured in batches to minimize assay variability. The key is if Lp(a) is very low or very high, it does vary around a preset

In fact, higher insulin levels tend to suppress Lp(a) via LPA promoter, which explains why pts with diabetes tend to have lower Lp(a) levels. So, preventing glucose spikes would tend to increase, not decrease Lp(a), so likely another variable at play.

This issue of glucose and Lp(a) needs more study. When one changes diet, i.e. less carbs to decrease glucose spikes, one has to add something else (more protein and fat) to maintain caloric balance, so there are multiple changing variables at play and one cant determine the

Not sure, but worthy of serious consideration.

Dr Akiro Endo, discoverer of mevastatin that opened the way for one of the most effective methods to reduce risk of heart attack/stroke, died today at age 90. Impact to human health benefits is incalculable, it is estimated 200,000,000 people are on statins. You can read more

Oscar, thank you for the invitation. It was a privilege to present Grand Rounds at such an esteemed institution, and the questions were excellent.

This is where the field may head eventually...

There are now 4 papers on the topic, where the evidence suggests, but does not prove, aspirin may reduce risk of future CVD events in patients with elevated Lp(a). However, they need validation in studies where aspirin was randomized at entry in modern cohorts. ASPREE did not

Its included, stay tuned on this, we have an editorial coming soon to address it. The LDL-C is at best an estimate, particularly in people with elevated Lp(a), hihg TGs or very low true LDL-C. ApoB does not solve this issues as it lumps all apoB together, irrespective of what is

Someone who has CVD, or lots of coronary calcium, or persistently high LDL-C. There are some other individualized cases also.

I dont think we have enough data on chimps in wild, but most don't live to a ripe old age. Note also they are not sedentary, quite the opposite, and have no other risk factors. Their LDL-C is also ~100.

MESA- there is no new idea under the sun that has not been though of already by someone else..

Yes, this is a topic of high interest for me, unfortunately I cannot obtain blood samples from those that have them to do addtional studies...