Background: Lipoprotein (a), also called Lp(a), is a cardiovascular disease (CVD) risk factor. Statins do not lower Lp(a), this may at least partly explain residual CVD risk in statin-treated patients with familial hypercholesterolemia (FH). We investigated the association of Lp(a) levels with atherosclerosis in these patients. Methods and results: We performed ultrasonography in 191 statin-treated FH patients (50% men; 48±15 years) to detect carotid plaques and determine carotid intima-media thickness (C-IMT).Patients with high versus low Lp(a) levels (≤0.3g/L) had similar plaque prevalence (36 and 31%, p=0.4) and C-IMT (0.59±0.12 and 0.59±0.13mm, p=0.8). Patients with and without plaques had similar Lp(a) levels (median 0.35 (IQR: 0.57) and 0.24 (0.64) g/L, respectively, p=0.4). Conclusions: The Lp(a) levels were not associated with atherosclerosis in the carotid arteries of statin-treated FH patients. This suggests that adequate statin treatment delays carotid atherosclerosis in FH independently of Lp(a) levels.

Carotid intima media thickness, Carotid plaque presence, Familial hypercholesterolemia, Lipoprotein (a), Residual risk,
Department of Pharmacology

Bos, S, Duvekot, M.H.C, Touw-Blommesteijn, A.C, Verhoeven, A.J.M, Mulder, M.T, Watts, G.F, … Roeters van Lennep, J.E. (2015). Lipoprotein (a) levels are not associated with carotid plaques and carotid intima media thickness in statin-treated patients with familial hypercholesterolemia. Atherosclerosis, 242(1), 226–229. doi:10.1016/j.atherosclerosis.2015.07.024