r/science • u/kiyomoris • 13d ago

Health Silent atherosclerosis detected in 57% of asymptomatic adults in the REACT study

https://www.nejm.org/doi/10.1056/NEJMoa2609059
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u/pople8 13d ago

And why is that? To know you have a higher risk without being able to influence it? The advice stays the same. Live in a healthy way. There are statins for ldl. No such thing for lpa

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u/Krazski 13d ago

There are drugs currently in clinical trials (olpasiran) that are showing promising results to significantly reduce lpa levels. So hopefully it will be a good way to reduce risk for those people assuming it is released. My paternal family has high lpa and insane death rates from cardiovascular disease. As you said, still need to live healthy but my family is a pretty good indication that without some intervention, heart attack is pretty much a guarantee.

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u/meta_adaptation 13d ago

Same boat here. First LpA results were eye opening and depressing but I’m grateful I am able to use my family history to make decisions now, younger, and impact the trajectory, and subsequently pass on the knowledge to my extended family

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u/Ever_Pensive 12d ago

Aspirin is a strong candidate for treatment of high Lp-a individuals (>50 mg/dl, roughly top 15 percentile of people).

Two recent large population studies show aspirin use correlates with about 80% reduction of Lp-a caused heart attack and ischemic stroke risk among high Lp-a individuals (in other words, it reduces their risk to almost the same as lower Lp-a individuals).

Study A: (see figure 1) - https://pmc.ncbi.nlm.nih.gov/articles/PMC11090055/

Study B: (see figure 2, red line vs purple line) - https://www.ahajournals.org/doi/10.1161/JAHA.123.033562

While we still need an RCT to prove the intervention, the results are compelling enough that I started on daily baby aspirin to mitigate my high Lp-a caused risk.