Conclusions Fibrates have a significantly greater effect in reducing plasma Lp(a ) concentrations than statins .
Addition of fibrates to statins can enhance the Lp(a)-lowering effect of statins
Background Raised plasma lipoprotein(a ) ( Lp(a ) ) concentration is an independent and causal risk factor for atherosclerotic cardiovascular disease .
Several types of pharmacological approaches are under evaluation for their potential to reduce plasma Lp(a ) levels .
There is suggestive evidence that statins and fibrates , two frequently employed lipid-lowering drugs , can lower plasma Lp(a ) .
The present study aims to compare the efficacy of fibrates and statins in reducing plasma concentrations of Lp(a ) using a meta- analysis of r and omized head-to-head trials .
Lipoprotein(a) levels and risk of future coronary heart disease: large-scale prospective data.
BACKGROUND Large-scale prospect i ve data are needed to determine whether associations between lipoprotein(a ) ( Lp[a ] ) and coronary heart disease ( CHD ) risk are independent of established risk factors , to characterize the shape of this relationship , and to quantify associations in relevant subgroups . METHODS Levels of Lp(a )  were measured in sample s obtained at baseline from 2047 patients who had first-ever nonfatal myocardial infa rct ion or who died of CHD during the study and from 3921 control participants in the Reykjavik Study ( n=18 569 ) , as well as in paired sample s obtained 12 years apart from 372 participants to quantify within-person fluctuations . RESULTS Baseline Lp(a ) levels had little or no correlation with known cardiovascular risk factors , such as age , sex , total cholesterol level , and blood pressure . The Lp(a ) values were highly consistent from decade to decade , with a regression dilution ratio ( calculated on the log scale ) of 0.92 ( 95 % confidence interval , 0.85 - 0.99 ) . The odds ratio for CHD , unaltered after adjustment for several established risk factors ( age , sex , smoking status , blood pressure , total cholesterol , triglycerides level , diabetes mellitus , and body mass index ) , was 1.60 ( 95 % confidence interval , 1.38 - 1.85 ) in a comparison of extreme thirds of baseline Lp(a ) levels . Odds ratios were progressively higher with increasing Lp(a ) levels and did not vary material ly by several individual- or study -level characteristics . CONCLUSIONS There are independent , continuous associations between Lp(a ) levels and risk of future CHD in a broad range of individuals . Levels of Lp(a ) are highly stable within individuals across many years and are only weakly correlated with known risk factors . Further assessment of their possible role in CHD prevention is warranted
Conclusions Fibrates have a significantly greater effect in reducing plasma Lp(a ) concentrations than statins .
Addition of fibrates to statins can enhance the Lp(a)-lowering effect of statins
Background Raised plasma lipoprotein(a ) ( Lp(a ) ) concentration is an independent and causal risk factor for atherosclerotic cardiovascular disease .
Several types of pharmacological approaches are under evaluation for their potential to reduce plasma Lp(a ) levels .
There is suggestive evidence that statins and fibrates , two frequently employed lipid-lowering drugs , can lower plasma Lp(a ) .
The present study aims to compare the efficacy of fibrates and statins in reducing plasma concentrations of Lp(a ) using a meta- analysis of r and omized head-to-head trials .