Granat Marcin Mateusz
Department of Clinical and Experimental Pharmacology, Faculty of Medicine, Medical University of Warsaw, 02-097 Warsaw, Poland.
Rev Cardiovasc Med. 2025 Jan 16;26(1):26162. doi: 10.31083/RCM26162. eCollection 2025 Jan.
Lipoprotein(a) (Lp(a)) serum concentration plays a crucial role as a risk factor in cardiovascular diseases and is gaining more and more attention. Patients with elevated lipoprotein(a) levels are often prescribed statins as they also have high concentrations of low-density lipoprotein cholesterol (LDL-C). Statins are drugs that successfully decrease LDL-C, but their effectiveness in Lp(a) levels reduction is uncertain. The aim of this study was to evaluate if statin therapy can affect Lp(a) concentration. A literature search on databases like PubMed, Oxford Academic, ScienceDirect, Embase, The Cochrane Library, Scopus, and Springer Link was conducted from 1 May to 10 August 2024 with the aim of finding studies concerning the effect of statins on Lp(a) levels. Only randomised control studies and studies with a placebo/comparator arm were included. For calculations, SPSS Statistics software version 29 was used. The risk of bias for this study was assessed using the revised Cochrane risk-of-bias tool for randomised trials. Overall, 43 studies (13,264 participants in study arms and 11,676 in control arms) were included in the analysis. The mean difference of absolute change in Lp(a) concentration for all 43 studies equaled 0.22 mg/dL and was not clinically significant. Egger's regression-based test resulted in no risk of bias in this study ( = 0.404). In conclusion, statin therapy does not significantly affect Lp(a) levels. Results of this work suggest that people with high Lp(a) levels will not change their Lp(a)-associated cardiovascular (CV) risk by statin administration.
脂蛋白(a) [Lp(a)] 的血清浓度作为心血管疾病的一个危险因素起着至关重要的作用，并且越来越受到关注。脂蛋白(a) 水平升高的患者通常会被开具他汀类药物，因为他们同时也有高浓度的低密度脂蛋白胆固醇（LDL-C）。他汀类药物是能够成功降低LDL-C的药物，但其降低Lp(a) 水平的有效性尚不确定。本研究的目的是评估他汀类药物治疗是否会影响Lp(a) 浓度。于2024年5月1日至8月10日在PubMed、牛津学术、ScienceDirect、Embase、考克兰图书馆、Scopus和施普林格链接等数据库上进行了文献检索，目的是查找有关他汀类药物对Lp(a) 水平影响的研究。仅纳入随机对照研究以及设有安慰剂/对照臂的研究。计算时使用了SPSS Statistics软件版本29。本研究的偏倚风险使用修订后的考克兰随机试验偏倚风险工具进行评估。总体而言，43项研究（研究组13264名参与者，对照组11676名参与者）纳入了分析。所有43项研究中Lp(a) 浓度绝对变化的平均差值为0.22mg/dL，无临床意义。基于Egger回归的检验结果显示本研究无偏倚风险（P = 0.404）。总之，他汀类药物治疗不会显著影响Lp(a) 水平。本研究结果表明，Lp(a) 水平高的人不会通过服用他汀类药物改变其与Lp(a) 相关的心血管（CV）风险。
