High Lipoprotein(a) but CAC Score 0

@leeosteo I do have high Lp(a) and my cardiologist recommended Repatha but did not mention studies. I declined taking Repatha for now because I don't feel it does enough and I want to wait until more information is available and those studies come up with a more effective treatment.

@dianempx // my Lp(a) was never that high, but I nearly halved mine from 92 nmol/L to 49 nmol/L by adopting a very low carb / keto diet. 10 mg rosuvastatin, 10 mg ezetimibe daily for 15+ years.

So high levels of Lp(a) might be hereditary but perhaps they can vary somewhat according to lifestyle?

There is no insurance approved treatment for lp(a), but there are drugs that have been proven to dramatically lower lp(a). The next step, that is ongoing, are studies that show lowering lp(a) lowers MACE. There's a study that is expected to conclude this year. Then FDA approval. Then insurance coverage. The studies I looked at for impact on MACE required 175 nmol/L or greater. So there's also the issue of who would qualify if/when it makes it to insurance coverage. Best case, a few years out? At least this is my uneducated understanding of the process.

@bitsygirl , what is MACE?

It stands for Major Adverse Cardiovascular Event. I think it includes cardiovascular death, heart attack, stroke, but I'm not certain.

@loriesco , I seem to remember your Mayo Connect name from the Osteoporosis Mayo Connect group. I'm on my 24th month of Forteo and looking at Reclast also. I take Krill oil daily along with VitD/K2 drops. The rest is diet. I track my nutrients via Cronometer.com. Supplement were needed.

I've been tracking my cholesterol since 2007 and have a good trend chart. My cholesterol starting going above normal range after menopause. Honestly, I believe my bones and cholesterol is menopause driven mostly, except for the new Lp(a) score. Now I know there's some genetics driving that. I'm curious your sequence for 5 yr Tymlos/Reclast. Is it 2 yrs Tymlos, 1 yr Reclast, another 2 yrs Tymlos? Also, may I ask your age? Just curious which doctor helped you to get bioidentical HRT? The research I've done re osteoporosis and now cholesterol has most of this connected to estrogen lose.

@bitsygirl , thanks

Great question @leeosteo.

I just looked up MACE to formally see what is included and have to laugh. You are a rock star, @bitsygirl!

Major Adverse Cardiac Event (MACE) is exactly what you stated…..sometimes. It is a term used in cardiovascular research used to determine an end-point of a study. Each study defines the exact description a bit differently making it difficult to compare at times. Also, makes bitsygirl “not certain” comment spot on!

Thanks for prompting me to smile this evening.

I recently went thru some testing, mainly because I requested some extra testing due to both my grandmother's stroke history.

I have a very high HDL and relatively high LDL, but a good ratio with low triglycerides. Most doctors don't even think about doing further testing because of the unusually high HDL and good HDL to LDL ratio and low triglycerides. Further tests though showed that I do have a slightly elevated ApoB (Apolipoprotein B) and a mild elevation of Lp(a) (Lipoprotein a) although my homocysteine levels are in the normal range. So the picture became more muddled.

So I have a mixed picture of cardio health....so CAC enters the picture.....

My doctor scheduled a CAC test. This showed a below 11 count in one artery and "mild" plaque on one valve. Copilot told me that both these places are where plaque is prone to accumulate, based on how the blood flows and moves. An ultrasound is scheduled to check to make sure that that small amount is not impeding the valve.

Then to gain a clearer picture.....

I took all the numbers and fed them to copilot to look up all the research and standards and tell me what all these tests together mean to me, and if I need any further tests to further clarify.
Copilot told me that the tests with the LDL and the APoB combined with the CAC showed that the LDL particles are likely larger and less numerous and the plaque CAC biology information showed that plaque accumulation is slow and non-aggressive due to my age, 73 and the low level of plaque even in the areas most prone to plaque accumulation with age.
Copilot: A Carotid Ultra Sound was recommended in the future for me because of the potential stroke risk in my family.

What I am saying is that the tests layer over one another to form a picture of cardio health.

It is like those progression pictures that we saw years ago where there was several pages that were meant to layer on top of one another; when they were all in place the picture emerged. All the tests layer onto one another and a full picture emerges when you put all the tests together.

I have found that copilot has been invaluable in helping me understand what is happening and how it affects and reflects my health. My doctor appreciates me using copilot because I am able to listen and understand her quickly because I have done the research before I see her, and I am not calling or going on line to ask her questions constantly about procedures, reasons and what this means. I can spend my time with my doctor more productively, and I am less stressed. Plus, plus!

@leeosteo my doctor prescribed repatha injections which lowered mine from 129 to 103.
There are medications in study trials currently. I have moved to another state and my new cardiologist has not Heard of the new drugs which is scary . Be sure and be your own advocate . He also displayed LP(@) and said everyone could have plaque break off and just live your life and don't worry about it. My last cardiologist was very different and concerned. health care is not so good anymore