Elevated Lp(a) levels - does Repatha help?

Whoa! That looks amazing. Thanks for the share.

I'm a 72 year old male - with mitro valve prolapse - with moderate to severe leakage.
My overall cholesterol is 189 with a cholesterol ratio of 2.5 - so my numbers are good.
I am active in the gym three times a week - my HDL (Good Cholesterol) is 76.7
My cardiologist ran an Lp(a) test - my first ever - my score was 243 - anything over 75 is bad.
She wants me to start repatha. I am currently on 10mg daily of lipitor.
Thoughts?

Appreciated.

I love my LEVQIO injections twice a year. I always tell the nurse it clears my sinuses and she laughs. I’m on year two and it really hasn’t done anything. My LPa is 66 to 88. My cholesterol is great and I continued to focus on diet and exercise. I can’t take statins because I get the muscle weakness and my dad took them for 25 years but it didn’t stop the plaque from laying down on his arteries. The numbers are there to tell you you have an issue and does not tell you necessarily the condition of your heart and arteries. A cardiologist has to interpret ALL the numbers and have pictures of your heart and arteries. Your age also has a bearing on the numbers.. Having a cardiologist is important because they will interpret all the puzzle pieces and give you an understanding and a regime to follow. Continue to do your own research so you can ask questions of the doctors team unfortunately the great numbers achieved when you control your blood serum, cholesterol, and lipids Are not indicative of what your body is actually doing. So it is helpful to understand the mechanisms of your body laying down plaque in your arteries. Keep up the good work where you can.

I have been on Repatha for 2 months. My Lp(a) level dropped by 32%. I don't take any other cholesterol meds. My cholesterol dropped by 35%, LDL by 61%. Chol/HDL Ratio is now 1.7. No noticeable side effects. I hope this is helpful. My cardiologist prescribed it.

Hi @paxlux, welcome to Mayo Clinic Connect. You have wonderful news to report about starting Repatha just 2 months ago! You must be beyond ecstatic about the drop in both your LDL and LP(a).

Since you are new here, would you share some about your health and what has led you to Repatha? Also, what type of follow-up will you have, when do you get numbers checked again?

I just recently started Repatha and on the day of my 4th shot, which is 2 month mark, my labs showed my Lpa went from 199 to 104 and my ApoB went from 129 to 90. My doctor told me today he would retest in like six weeks. He also mentioned that hopefully next year there would be new meds available that would be more effective for reducing Lpa.

I just recently started Repatha. After my 4th shot, two months, my Lpa went from 199 to 104 and my ApoB went from 129 to 90. My doctor said he would test again in @6weeks. He also mentioned that new meds should be coming out that will be more effective in reducing Lpa. It was my general doctor that's an internal medicine doctor that prescribed it.

Received lab test results of 320 for lipoprotein a last week. Putting me on Repatha until future drugs come to market. Hope I can last that long

Hi, @bobinindiana

That is definitely elevated. I also have high lp(a) but not that high. I have atherosclerosis in various places, but none of concern at this point. I've exercised regularly and eaten pretty well, so I attribute it at least partly to lifestyle. I don't know her lp(a) level, but at my age my mother had already had a triple bypass. When she died, the doctors said they didn't really know why but attributed it to the level of atherosclerosis throughout her body. So I am sticking with the exercise and diet!

Here's a website that has information on lipoprotein(a) https://familyheart.org/high-lipoprotein-a. There's a trial ending soon that took people with >70 mg/dL. It's Pelacarsen’s Lp(a)HORIZON Phase 3 trial testing whether reduction of lipoprotein(a) lowers the rate of major cardiovascular events. AI tells me the results are expected in late 2025/2026, but it depends on how the different groups in the study fare. So there's no predictable "end date" as I understand it. There are a couple of other trials with similar goals: ACCLAIM‑Lp(a) and OCEAN(a)‑Outcomes. Then FDA approval and insurance approval. So a few years I guess. But, atherosclerosis also progresses slowly so hopefully it can help us.

You may already know all this. On the plus side, sounds like your cardiologist is knowledgeable about lp(a). My cardiologist shut me down completely when I asked about a PCSK9 inhibitor. I can only guess why he won't support it.

@bitsygirl
Thanks for your information. Similar to what I am finding. I did see a process similar to dialysis where it cleans the blood but don’t think I qualify. I had a double bypass 34 years ago and then a CTO 5 years ago when my widow maker was 100 % clogged. Thank goodness I developed some ancillary paths so made it through that procedure. Just turned 80 but not giving up