ALFA
Research type
Research Study
Full title
Assessment of Lipoprotein(a) and endogenous Fibrinolysis in Atherosclerotic cardiovascular disease/aortic valve disease
IRAS ID
330225
Contact name
Diana A. Gorog
Contact email
Sponsor organisation
East and North Hertfordshire NHS Trust
Duration of Study in the UK
4 years, 0 months, 0 days
Research summary
The risk of a clot forming in a blood vessel, which can cause a heart attack or stroke, is determined partly by how “sticky” the blood is and partly by the effectiveness of the natural defences in the blood in dissolving any clots that start forming (clot lysis, or “fibrinolysis”).
In the last few years, using new blood testing techniques, we and other groups, have shown that individuals who have less effective natural clot lysis, have a much higher risk of heart attack, stroke and death, even despite current best medications
Therefore, we would like to find medications that can make clot lysis more effective, in such individuals, to reduce their risk of stroke and heart attack. Unfortunately, most blood thinning tablets for long term use do not improve clot lysis. Earlier, our group has shown that the anticoagulant apixaban, mildly improved clot lysis.
Lp(a) is similar to low-density lipoprotein, sometimes called “bad” cholesterol, but is more ‘sticky’ and high levels in the blood increase the likelihood of an individual having a heart attack, a stroke, and narrowing of the aortic valve even further. One of the ways it is proposed to exerts is negative affect is by impairing clots lysis.
To date, no therapies have been able to sufficiently reduce Lp(a) and therefore it was considered to be a non-modifiable cardiovascular risk factor. New data, however, has shown that PCSK9 inhibitors and inclisiran (medication that you have been deemed eligible for in order to help further reduce your cholesterol levels) to reduce Lp(a) levels by approximately 20-25%.
We would now like to assess if levels of Lp(a) are associated with clot lysis in 2 different cardiovascular cohorts and also to assess whether lowering Lp(a) with PCSK9 inhibitors or inclisiran can improve this.
REC name
East of England - Cambridge Central Research Ethics Committee
REC reference
23/EE/0182
Date of REC Opinion
4 Oct 2023
REC opinion
Further Information Favourable Opinion