A 67-year-old man with peripheral vascular disease presents with chest discomfort. Vital signs: BP 158/92 mmHg, HR 88 bpm, RR 16, SpO2 98% on room air. He takes high-dose simvastatin. Labs show LDL cholesterol 95 mg/dL, lipoprotein(a) 85 nmol/L (normal <50), and normal triglycerides at 120 mg/dL. Troponin is negative. Despite achieving LDL goals, which lipoprotein fraction best explains his persistent cardiovascular risk?

  1. A)Lipoprotein(a) has proatherogenic and prothrombotic properties independent of LDL-CGABARITO
  2. B)Lipoprotein(a) increases hepatic cholesterol synthesis by feedback inhibition
  3. C)Lipoprotein(a) is primarily composed of free cholesterol that cannot be measured by standard lipid panels
  4. D)High lipoprotein(a) directly reduces lipoprotein lipase activity
  5. E)Elevated lipoprotein(a) inhibits the anticoagulant effects of statins

Explicação

Lipoprotein(a) [Lp(a)] is an independent risk factor for atherosclerotic cardiovascular disease, carrying an ApoB-100 particle with an additional ApoA moiety structurally similar to plasminogen. It has intrinsic proatherogenic properties (inflammation, endothe... Ver explicação completa e trilha adaptativa →

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