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  • 7 months ago
(Adnkronos) - Quando si parla di rischio cardiovascolare “non esiste un identikit valido per tutti i soggetti, ognuno ha la sua categoria di rischio che viene determinata sulla base di alcune caratteristiche cliniche, tra cui i livelli di colesterolo e glicemia, l’ipertensione arteriosa e il fumo di sigaretta. Sulla base di questo, noi clinici siamo in grado di valutare, attraverso degli score, il rischio del paziente, da basso a moderato, fino a elevato e molto elevato. In relazione alla categoria di rischio andiamo ad adattare lo screening cardiovascolare e a decidere i target terapeutici da raggiungere”. Sono le parole di Mario Crisci, dirigente medico Uoc Cardiologia interventistica, Aorn dei Colli - ospedale Monaldi, Napoli, intervenendo all’incontro ‘Non solo colesterolo Ldl: alla scoperta della Lipoproteina (a)’ organizzato da Novartis a Milano.

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00:00There is not a valid tooth kit for all subjects of cardiovascular risk, each subject has
00:10its own category of risk and that category of risk is determined on the basis of some
00:14clinical characteristics such as cholesterol, arterial hypertension, glycemia, cigarette
00:19smoke and therefore on the basis of this we are, we clinicians, we are able to go and
00:24evaluate through the slides what the patient's risk is and divide it into categories from
00:28low to moderate to high and very high.
00:32On the basis of the patient's risk category, we go to adapt what is his
00:37cardiovascular screening and eventually to decide what are the therapeutic targets to
00:41reach, let's say, substances that are more dangerous such as LDL, such as glycemia,
00:48such as blood pressure.
00:49This, let's say, obviously has a big impact in the field of population screening and should
00:54always be carried out during a simple visit or general medicine or cardiology.
00:59Ripoprotein A is precisely today an additional risk factor that has been categorized as
01:04an independent risk factor compared to the others, but in addition to being independent, it also has the
01:09ability to worsen the risk of the patient who normally presents other risk factors,
01:15that is, to explain myself better, if a patient has a hypercholesterolemia, a hypertension
01:20and therefore enters a moderate risk category, if he has high levels of ripoprotein A, this
01:25puts him in a higher risk category, that is, he becomes a high risk instead of moderate.
01:31But what is this ripoprotein A?
01:33Ripoprotein A is nothing more than a component of LDL and it is a component that makes that
01:38LDL even more bad, that is, already the base LDL is atherogenic, with ripoprotein A we identify
01:43that LDL which is even more atherogenic, which goes even more easily to attack our
01:48bases.
01:49Ripoprotein A is very easy to test, with a normal, classic blood test and above all
01:55it is genetically determined, so it is enough to measure it only once in the life of a subject
02:00and we already have a fairly significant estimate of its value, with small oscillations in the
02:05field of life.
02:06It is precisely for these characteristics that I have just underlined, obviously ripoprotein
02:09A is today considered one of the targets to be addressed in the therapeutic field and
02:13new therapies are being developed because currently only plasmapheresis is able to
02:18significantly reduce these levels, but it is a fairly invasive technique, while from
02:22a pharmacological point of view no other molecule has a big impact on ripoprotein A.
02:27However, studies are underway with ASO and SIRNA, which are new technologies, let's say
02:31very innovative pharmacies, which can significantly reduce the risk of RPA and therefore reduce
02:37the cardiovascular risk of our patients.
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