Lipoprotein (a) in Cardiovascular Risk Assessment and Management in Diabetes Mellitus

Authors

  • Gordon A. Francis, MDCM, FRCPC, FAHA Department of Medicine, Centre for Heart Lung Innovation, Providence Research, St. Paul’s Hospital, University of British Columbia

DOI:

https://doi.org/10.58931/cdet.2023.1315

Abstract

Lipoprotein (a) [Lp(a)] is an independent and genetically-determined risk factor for coronary heart disease (CHD) and stroke that is not changed by alterations in lifestyle factors. It is now recommended by Canadian and other national lipid guidelines to be measured once in a person’s lifetime as part of overall assessment for cardiovascular risk, along with family history; presence of hypercholesterolemia; Type 2 diabetes (T2DM); hypertension; and smoking. The presence of elevated Lp(a) confers additional risk to the already high cardiovascular risk in individuals with T2DM. This review summarizes the nature and association of Lp(a) with elevated cardiovascular disease (CVD) risk; the increased cardiovascular risk in individuals with T2DM; potential therapies to lower Lp(a); whether or not to measure Lp(a); and recommendations on how to respond to the finding of elevated Lp(a) in a patient with T2DM.

Author Biography

Gordon A. Francis, MDCM, FRCPC, FAHA, Department of Medicine, Centre for Heart Lung Innovation, Providence Research, St. Paul’s Hospital, University of British Columbia

Dr. Gordon A. Francis is a Professor of Endocrinology and Metabolism, Department of Medicine and an investigator in the Centre for Heart Lung Innovation at the University of British Columbia. He is a member and was previous director of the Healthy Heart Program Prevention/Lipid Clinic at St. Paul’s Hospital from 2007-2020, and a clinical member of BC Diabetes. He is a member of the Canadian Cardiovascular Society Lipid Guidelines Panel, where he has led subcommittees recommending the use of non-HDL-C and apoB as preferred lipid targets over LDL-C, instituting non-fasting lipid testing, and routine measurement of Lp(a).  He holds a Michael Smith Health Research/Providence Research Health Professional Investigator award. His research has identified that smooth muscle cells rather than macrophages are the source of the majority of foam cells in atherosclerosis, and is studying whether or not these cells represent a novel target for therapy beyond currently available lipid-lowering medications.

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Published

2023-10-12

How to Cite

Francis, G. A. (2023). Lipoprotein (a) in Cardiovascular Risk Assessment and Management in Diabetes Mellitus. Canadian Diabetes & Endocrinology Today, 1(3), 5–9. https://doi.org/10.58931/cdet.2023.1315

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Volume 1, Issue 3, October 2023

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Articles

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