Jan Niclas Strickling

HealthBay Day Surgery Center, United Arab Emirates

Title: Management Of Elevated Lipoprotein (A) In Preventive Cardiovascular Medicine

Biography

Strickling is a highly experienced Consultant inInternal Medicine and Cardiology, with over 12 years of clinical practice inleading tertiary care hospitals across Germany. He holds dual German BoardCertifications—Internal Medicine (2018) and Cardiology (2021)—and has developedcomprehensive expertise in the diagnosis and treatment of both internal andcardiovascular diseases.

Strickling has extensive proficiency inabdominal ultrasound and echocardiography, and he is recognized for hisoutstanding capabilities in both invasive and non-invasive cardiology. Mostrecently, he served as the Head of the Department of Device Therapy and HeartFailure, where he led advanced treatment programs and managed complex cardiacconditions.

A specialist in pacemaker and defibrillatortherapy, Dr. Strickling also brings advanced skills in invasive coronarydiagnostics and emergency myocardial infarction care. His commitment toclinical excellence is further underscored by additional certifications fromthe German Society of Cardiology in active cardiac rhythm implants, heartfailure management, and interventional cardiology.

Abstract

The management of elevated Lipoprotein (a) in preventive cardiovascular medicine remains challenging as we still await target medication. Lipoprotein (a) plays a crucial role as cardiovascular risk factor causing early calcifications to coronary vessels and aortic valve disease. It effects up to 20% of world population. Lipoprotein (a) is an attachment to the LDL cholesterol making it 3-5 times more atherogenic than LDL cholesterol alone. Lipoprotein (a) levels should be checked if early or recurrent cardiovascular events occur, in familial hypercholesterinemia or if elevated Lipoprotein (a) levels were diagnosed in family members. Neither healthy diet nor extensive exercise lower the levels of Lipoprotein (a) as it is genetically elevated. Levels remain stable over lifetime, therefore a once in a lifetime testing is sufficient.

Currently RNA based drugs show remarkable results in reducing Lipoprotein (a) levels by silencing the gene responsible for production in liver cells but are not available yet. Ongoing phase 3 trials are evaluating cardiovascular benefits of Lipoprotein (a) reduction.

Until target therapy is available, screening for other cardiovascular risks and rigorous treatment are the only options. Resulting in an goal of LDL reduction to < 40 mg/dl in patients under risk for an early cardiovascular event. It remains the subject of current research how to deal with elevated Lipoprotein (a) in low-risk patients.