{"id":"75d5823d3c00","type":"article","url":"https://hartvaat.nl/2020/06/21/statinetherapie-verhoogt-lipoproteine-a-spiegels/","title":"Statinetherapie verhoogt lipoproteïne(a)-spiegels","title_en":"Statin therapy increases lipoprotein(a) levels.","category":"cholesterol","category_label":"Cholesterol","professions":["apotheker","cardioloog","internist"],"tags":["dyslipidemie","ldl-cholesterol","lipide-aferese","lipidenverlaging","lipoproteïne-a","lipoproteïne-a-therapeutisch-doel","pelacarsen"],"journal":"European heart journal","doi":"10.1093/eurheartj/ehz310","source_url":"https://doi.org/10.1093/eurheartj/ehz310","authors":["Sotirios Tsimikas","Philip L S M Gordts","Chelsea Nora","Calvin Yeang","Joseph L Witztum"],"significance":7,"published":"2020-06-21","source_date":"2020-06-21","image":"","kennis":["https://hartvaat.nl/kennis/lipiden/lipidenmedicatie-bij-ckd/","https://hartvaat.nl/kennis/lipiden/lpa-meten-wanneer-waarom/"],"congress":"","summary_en":"This study confirmed that statin therapy paradoxically increases lipoprotein(a) levels, an effect with potential clinical relevance for the assessment and management of Lp(a)-related residual cardiovascular risk during statin treatment.","created":"2026-07-03T10:28:38Z","updated":"2026-07-03T13:27:48Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Studie die bevestigt dat statinetherapie Lp(a)-spiegels verhoogt. Paradoxaal effect met klinische relevantie voor residueel risico.","abstract_original":"AIMS: Lipoprotein(a) [Lp(a)] is elevated in 20-30% of people. This study aimed to assess the effect of statins on Lp(a) levels. METHODS AND RESULTS: This subject-level meta-analysis includes 5256 patients (1371 on placebo and 3885 on statin) from six randomized trials, three statin-vs.-placebo trials, and three statin-vs.-statin trials, with pre- and on-treatment (4-104 weeks) Lp(a) levels. Statins included atorvastatin 10 mg/day and 80 mg/day, pravastatin 40 mg/day, rosuvastatin 40 mg/day, and pitavastatin 2 mg/day. Lipoprotein(a) levels were measured with the same validated assay. The primary analysis of Lp(a) is based on the log-transformed data. In the statin-vs.-placebo pooled analysis, the ratio of geometric means [95% confidence interval (CI)] for statin to placebo is 1.11 (1.07-1.14) (P < 0.0001), with ratio >1 indicating a higher increase in Lp(a) from baseline in statin vs. placebo. The mean percent change from baseline ranged from 8.5% to 19.6% in the statin groups and -0.4% to -2.3% in the placebo groups. In the statin-vs.-statin pooled analysis, the ratio of geometric means (95% CI) for atorvastatin to pravastatin is 1.09 (1.05-1.14) (P < 0.0001). The mean percent change from baseline ranged from 11.6% to 20.4% in the pravastatin group and 18.7% to 24.2% in the atorvastatin group. Incubation of HepG2 hepatocytes with atorvastatin showed an increase in expression of LPA mRNA and apolipoprotein(a) protein. CONCLUSION: This meta-analysis reveals that statins significantly increase plasma Lp(a) levels. Elevations of Lp(a) post-statin therapy should be studied for effects on residual cardiovascular risk."}