“20” percent of humans have elevated lipoprotein (a), putting them at risk for heart attack, stroke, and aortic stenosis. Unfortunately, only 3/10 of a percent (.3 percent ) of U.S. primary care physicians ever test their patients, unlike physicians in the EU and Canada.
The link below will offer more information so that some readers are prepared to ask for this test when they have their traditional cholesterol check up. It is inexpensive to add the test into the regular cholesterol test. People may also choose to go to Quest and privately pay under $100 for a cholesterol panel that includes lipoprotein(a).
*** The test is particularly important for those whose parents and/or siblings demonstrated premature cardiac disease. It is a genetic issue and therefore can be inherited and passed on. It is not a lifestyle issue. Heart Associations and cardiologists say that no LDL is ever too low.
Hypercholesterolemia is a genetic issue. That's the exception not the rule. The other causes are lifestyle related. I recommend reading the link I referenced in my response to your other post.Serum cholesterol levels are not the reason of heart disease. After reading the whole series written by Dr Peter Attia everyone will understand this perfectly.
If heart disease was not lifestyle related we would not have such an explosion in heart disease rates during the last century.
More on this fascinating topic with many unknowns:
The Future of Medicine Is RNA
F. Perry Wilson, MD, MSCE
November 13, 2023 Medscape.com
Okay, it's not that simple. siRNA is broken down very quickly by the body, so it needs to be targeted to the organ of interest — in this case, the liver, since that is where lipoprotein(a) is synthesized. Lepodisiran is targeted to the liver by this special targeting label here.
The report is a standard dose-escalation trial. Six patients, all with elevated lipoprotein(a) levels, were started with a 4-mg dose (two additional individuals got placebo). They were intensely monitored, spending 3 days in a research unit for multiple blood draws followed by weekly, and then biweekly outpatient visits. Once they had done well, the next group of six people received a higher dose (two more got placebo), and the process was repeated — six times total — until the highest dose, 608 mg, was reached.
This is an injection, of course; siRNA wouldn't withstand the harshness of the digestive system. And it's only one injection. You can see from the blood concentration curves that within about 48 hours, circulating lepodisiran was not detectable.
But check out these results. Remember, this is from a single injection of lepodisiran.
Lipoprotein(a) levels start to drop within a week of administration, and they stay down. In the higher-dose groups, levels are nearly undetectable a year after that injection.
It was this graph that made me sit back and think that there might be something new under the sun. A single injection that can suppress protein synthesis for an entire year? If it really works, it changes the game.
Of course, this study wasn't powered to look at important outcomes like heart attacks and strokes. It was primarily designed to assess safety, and the drug was pretty well tolerated, with similar rates of adverse events in the drug and placebo groups.
As crazy as it sounds, the real concern here might be that this drug is too good; is it safe to drop your lipoprotein(a) levels to zero for a year? I don't know. But lower doses don't have quite as strong an effect.
Trust me, these drugs are going to change things. They already are. In July, The New England Journal published a study of zilebesiran, an siRNA that inhibits the production of angiotensinogen, to control blood pressure. Similar story: One injection led to a basically complete suppression of angiotensinogen and a sustained decrease in blood pressure.
I'm not exaggerating when I say that there may come a time when you go to your doctor once a year, get your RNA shots, and don't have to take any other medication from that point on. And that time may be, like, 5 years from now. It's wild.
Seems to me that that rapid Nobel Prize was very well deserved.
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