Rodrigo Guarch is 48 years old and has already suffered a heart attack and two strokes. He read the Clarín article on lipoprotein a (Lp(a)), published this Thursday, and wanted to tell his experience. His story reflects what generally happens with the diagnosis of this type of bad cholesterol, of genetic origin, which is not usually studied in routine tests.
The fact of not knowing why what happens to him and other patients happens to them anguishes them. And the answers are delayed. High lipoprotein A is present in one in five people and is a risk factor that adds to the so-called bad cholesterol (LDL), which is conditioned by environmental factors and lifestyle.
In the case of Lp(a) this is not the case and, for now, there is no medication that can combat it. But there are promising phase 2 and 3 drug trials, some of which are underway in Argentina.
"I had a heart attack in the anterior descending artery at age 34. He was a smoker, two tied up a day and sedentary life. I was hospitalized for almost a month in the Argerich until they managed to anticoagulate as a precaution. Final diagnosis: heart attack due to your lifestyle. Quit smoking, eat better, exercise, work less," Rodrigo tells Clarín.
"At 41 I had my first ischemic stroke. I realized in the office when I could not type correctly, from one moment to another it seemed that I had never seen a keyboard. I was interned in Los Arcos. A week after thousands of studies, it was a stroke for no apparent reason. I didn't smoke anymore, I ate better, but my life was sedentary. Luckily I didn't have sequelae. Take care of yourself, they told me, take the remedies," he says.
"A month after that episode I made an appointment with a cardiologist in the family, Dr. Balza Moreno, who asked me again for a blood test, but I wanted a special one." That's when for the first time they wanted to know this value in blood that is not usually studied: "I wanted to see my Lp (a) because a heart attack and a stroke at age 42 caught his attention. In effect, the Lp(a) was greater than 240".
Indeed, a value of 240 mg/dl is very high. Gustavo Giunta, coordinator of the Lipids and Atherosclerosis area of the Favaloro Foundation, explained to Clarín that a high value of lipoprotein (a) is considered when it is greater than 50 mg / dl and very high when it exceeds 180 mg / dl.
The estimate, for now theoretical, is that when anti-lipoprotein medication is available, it could be administered to those patients with values above 90/100 mg / dl.
Rodrigo, an administrative employee of an international organization and resident of Palermo, reaches the point in the story where the situation began to clarify: "Dr. Balza Moreno told me then, 8 years after treatments in clinics, hospitals, cardiologists and neurologists: 'Rodrigo, this is your problem. There are no medications for this, but you have to lose weight, lower your cholesterol as much as you can, and there will probably be no more problems. Oh, and when your kids are 10 years old, have them tested for the Lp(a). You can medicate them against cholesterol earlier and you're probably not going to have these kinds of problems."
In the equation of potential atherosclerosis, good (HDL) and bad (LDL) cholesterol are added to Lp(a).
But the episodes did not end there: "Last year, in the middle of the World Cup, I had my second stroke, this time it was in the cerebellum. Unfortunately it was bad with the taking of remedies. I would take them sautéed, or forget to make the prescriptions and it took two weeks to have them. I think it came over there. I was hospitalized again for a week. As soon as I entered, I mentioned to three different neurologists that I had an increased Lp(a). I have more than four blood tests that week and my Lp(a) was never measured. They looked for arrhythmias, walls of the heart with some hollow, etc. The diagnosis was stroke for no apparent reason."
Rodrigo ends his story: "Just a month after seeing the results the external neurologist of the clinic where I was hospitalized asked me for another blood test that included the Lp(a) and told me: 'You know that yes, I saw 3 other young patients with stroke the last year that has high Lp(a)".
Today, Rodrigo says that he already has two children (13 and 11 years old) and that he does not stop living with uncertainty. He reflects: "Not only to think that something can happen to me, but that in the future it can be a problem for them makes me bad. But I'm glad to hear that there are drug studies underway on this issue. If not for me, at least for them in the future."