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.

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Keywords Carotid intima media thickness, Carotid plaque presence, Familial hypercholesterolemia, Lipoprotein (a), Residual risk
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Journal Atherosclerosis
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