210 - Lp(a) and its impact on heart disease | Benoît Arsenault, Ph.D.& Peter Attia, M.D. | Peter Attia MD

In this episode of The Drive, Peter Attia interviews Benoît Arsenault about lipoprotein little a (Lp(a)), a genetically determined risk factor for cardiovascular disease and aortic stenosis. They discuss the history of Lp(a) research, the challenges in accurately measuring Lp(a) levels, and the causal role of Lp(a) in atherosclerotic cardiovascular disease. They explore the biology of Lp(a), including its production in the liver, its association with oxidized phospholipids, and its homology with plasminogen. The conversation covers the inheritance of Lp(a), the limitations of using niacin to lower Lp(a), and the potential benefits of PCSK9 inhibitors. They also discuss the importance of managing other modifiable risk factors, such as LDL cholesterol, blood pressure, and lifestyle, in individuals with elevated Lp(a). Finally, they touch on emerging therapies, such as antisense oligonucleotides, that specifically target Lp(a) production.

Outlines

Sign in to continue reading, translating and more.

Continue

210 - Lp(a) and its impact on heart disease | Benoît Arsenault, Ph.D.& Peter Attia, M.D.

Peter Attia MD

Introduction to Lipoprotein Little A (LpA) and its Discovery

Measurement Challenges, Genetic Studies, and Causal Role of LpA

Clinical Assays, Measurement Units, and the Impact of Statins on LpA

Atherogenicity of LpA, Oxidized Phospholipids, and Aortic Valve Stenosis

LpA and Aortic Valve Stenosis, Isoform Size, and Genetic Influence

Inheritance of LpA, Genetic Variants, and Clinical Guidelines

Extreme LpA Levels, Niacin Therapy, and Mendelian Randomization

CETP Inhibitors, ApoB, and the Prevalence of Elevated LpA

Awareness, Shared Decision-Making, and Genetic Associations

Atherogenicity, Oxidized Phospholipids, and OxLDL Assays

PCSK9 Protein, Familial Hypercholesterolemia, and LDL Receptors

PCSK9 Inhibitors, Clinical Trials, and LpA Reduction

Current Management Strategies and Future Therapies

210 - Lp(a) and its impact on heart disease | Benoît Arsenault, Ph.D.& Peter Attia, M.D.

Peter Attia MD

00:01Introduction to Lipoprotein Little A (LpA) and its Discovery

Introduction to Lipoprotein Little A (LpA) and its Discovery

12:33Measurement Challenges, Genetic Studies, and Causal Role of LpA

Measurement Challenges, Genetic Studies, and Causal Role of LpA

21:35Clinical Assays, Measurement Units, and the Impact of Statins on LpA

Clinical Assays, Measurement Units, and the Impact of Statins on LpA

35:20Atherogenicity of LpA, Oxidized Phospholipids, and Aortic Valve Stenosis

Atherogenicity of LpA, Oxidized Phospholipids, and Aortic Valve Stenosis

46:00LpA and Aortic Valve Stenosis, Isoform Size, and Genetic Influence

LpA and Aortic Valve Stenosis, Isoform Size, and Genetic Influence

56:21Inheritance of LpA, Genetic Variants, and Clinical Guidelines

Inheritance of LpA, Genetic Variants, and Clinical Guidelines

1:07:27Extreme LpA Levels, Niacin Therapy, and Mendelian Randomization

Extreme LpA Levels, Niacin Therapy, and Mendelian Randomization

1:15:39CETP Inhibitors, ApoB, and the Prevalence of Elevated LpA

CETP Inhibitors, ApoB, and the Prevalence of Elevated LpA

1:23:35Awareness, Shared Decision-Making, and Genetic Associations

Awareness, Shared Decision-Making, and Genetic Associations

1:37:20Atherogenicity, Oxidized Phospholipids, and OxLDL Assays

Atherogenicity, Oxidized Phospholipids, and OxLDL Assays

1:47:06PCSK9 Protein, Familial Hypercholesterolemia, and LDL Receptors

PCSK9 Protein, Familial Hypercholesterolemia, and LDL Receptors

1:57:10PCSK9 Inhibitors, Clinical Trials, and LpA Reduction

PCSK9 Inhibitors, Clinical Trials, and LpA Reduction

2:10:33Current Management Strategies and Future Therapies

Current Management Strategies and Future Therapies