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Estimation of the required lipoprotein(a)-lowering therapeutic effect size for reduction in coronary heart disease outcomes: a mendelian randomization analysis

JAMA Cardiology Jun 26, 2019

Lamina C, et al. - Via this Mendelian randomization analysis, researchers assessed the required Lp(a)-lowering effect size that may be correlated with a decline of coronary heart disease (CHD) outcomes vs the effect size of low-density lipoprotein cholesterol (LDL-C)-lowering therapies. Outcomes support lowering of lipoprotein(a) by 65.7 mg/dL to attain the identical potential effect on clinical outcomes as lowering low-density lipoprotein cholesterol by 38.67 mg/dL. However, the observed effect estimates of single-nucleotide polymorphisms on Lp(a) concentrations were used to determine this figure, so it is influenced by the standardization of the Lp(a) assay used. Therefore, there may have been an overestimation in calculations of the needed Lp(a)-lowering potential of a drug to be clinically effective in the past.

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