I seem to be falling between the cracks of NHS care.
My LDL has never been a problem, but I have calcified arteries.
Then, just six months ago I discovered I had significantly elevated LP(a). The nasty twin brother of LDL that likes to stick in your arteries.
So I was prescribed 10 mg Ezetimibe, but paradoxically my LP(a) has now shot up from 120 to 195nmol/l) 🙃
My diet, exercise and other meds - 5mg rosuvastatin - remain the same.
I paid for a private consultation with a cardiologist, but unfortunately he was as bemused as I am.
Because of my low LDL, the NHS is unlikely to help me with PCSK9 inhibitors and I seem to have missed the boat with the mRNA trials for the LP(a) wonder drugs coming down the line in the next ten years.
I’d love to hear from anyone else in my situation.
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Wumpmug
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Sad to report my Lp(a) is similar. I passed elevated Lp(a) on to one of our kids. He and I both take Rosuvastatin at 20 mg. I knew something was wrong because my dad, brother, and sister all had very premature cardiac disease, despite healthy living. My brother died at 53 from a clot in his heart. I only learned of Lp(a) in January of 2022, and I instantly knew that must be the problem my dad inherited. He was born in Sweden and his dad, brother, etc. had cardiac issues.
My cardiologist wants my LDL as low as possible. It was 48 when tested after 6 weeks on Rosuvastatin. I have not had any tests to evaluate my arteries, but in age, I am long past my sister’s emergency open heart surgery and my dad’s and brother’s fatal heart attacks.
I believe in a couple years there will be a treatment for elevated Lp(a). In the meantime, the Repatha shot works like a statin and also lowers Lp(a). Unfortunately, it is a PCSK9 inhibitor and very expensive. In the U.S. my two friends who take it are somewhat covered by insurance.
My cardiologist does not think I need to see an Lp(a) specialist. Instead his plan for me is profoundly lowering my LDL. He chose Rosuvastatin (Crestor) or he might have chosen Atorvastatin, both INTENSE statins.
I won’t get into the specifics of my diet, but will say it is not a typical American one with extra fats and sugars.
Amgen is trialing in phase 3 olpasiran which is looking very successful reducing Lp(a) up to a year and it is considered safe!
I also lost two siblings to heart disease. My father's side of the family all died with heart disease. I found a report depending on the level of Lpa the risk factors could be controlled following healthy lifestyle. My choice through research is to follow a high fat ultra low sugar diet that works for me. My Lpa value was 79mmol/l. I take 20mg of Atoravastatin.
I had a cabgx2 on July 2023, but my last CT showed no further calcium buildup on the already calcified arteries or with the bypass vessels.
So eating cholesterol rich foods does not raise cholesterol. The NHS Advice use to say not to eat too many eggs but they have changed advice.Same with saturated fat, eating fat doesn't make you fat.
The true cardiovascular marker is triglycerides/hdl, anything below 1 is a good indication, my result is 0.4 as my trigs are 0.5.
As the science seems to be finally catching up with the ‘statins cure all’ fallacy, I wonder what other blood stats you have going on that might be related to your LP(a) levels. Have you had a CRP (c-reactive protein) test or a HbA1c (3 month average blood sugar indicator) test? If these results are abnormal then the issue may be inflammation or insulin resistance(or both) and perhaps (maybe not, I’m no doctor) these numbers might point you towards a dietary change solution. Sorry if this is an area you have already fully addressed.
I have come to believe by literally hundreds of hours of investigation that my diet (high-carb, low fat, low dairy, as recommended by our wonderful uk government) was the cause of my pre-diabetes. In 3 weeks since changing my diet my HbA1c score dropped out of the pre-diabetes range! If my investigations are correct (I constantly search for all opinions so as to alleviate confirmation bias) then T2 diabetes (pre or full-onset) represents the biggest risk to atherosclerosis and heart health.
I have been on statins and clopidogrel (5 years+), Ezitimebe (2 years), and while my ldl cholesterol is good, I still had the ongoing pre-diabetes which arrived (weirdly enough) not too long after starting the statins.
Reading above, I think davebal67 has also seen the light! Diet is definitely key. Congrats on your results!
It’s just food for thought and I thought it might help. Don’t think I have had my LP(a) measured, mind. Was it easy to get ordered by your GP as I haven’t known many people who’ve been offered this?
Good luck with resolving your health issues with whatever choices you make. At the end of the day, we are all responsible for our own health and what suits one rarely suit all.
I got my speciality bloods done by insurance. I had Aopl A and B taken. My cardiologist even commented how low my apol b was, I also had fasting insulin taken and my Homa score was 1.2.
The truth is dietary sugar is the nemesis and not saturated fat.
My biggest take is flatten blood sugar daily and all your bloods will come into the optimum range.
I'm with you on the sugars. I have removed all refined sugar from my diet and only eat berries and other low sugar fruits. The change in my HbA1c score in just 3 weeks was unbelievable. I'd been trying for years to get this down!
Also, as an afterthought: what are your Apo(a), Apo(b) levels plus ratio showing? I believe the Apo(b) protein sits on every lp(a) cell as well on VLDL and all other atherosclerotic cells. If you haven’t had these tests then it may well be worth having them done?
We clinicians have not been enthusiastic about testing LPa because no treatment was available until very recently. I take a wait and see approach after the new treatment has been used among patients for a while. I also test homocysteine levels in patients with coronary disease without obvious risk factors. We have treatments available for elevated homocysteine levels which can cause coronary artery disease.
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