Cardiovascular diseases are common for men and women but there are differences between the sexes in terms of clinical symptoms, pathophysiology and response to the treatment. Cardiovascular diseases (CVD) in women is commonly underdiagnosed and often women tend to have a lower perception of the risk. That can lead to delayed diagnosis and failed recognition of symptoms. Women develop heart diseases later than men because of the protection in the reproductive phase of their life. Once they enter menopause the risk increases. Estrogen provides a protective effect against heart disease in women. Therefore, the risk of CVD increases after menopause in most cases. The presented work emphasizes the importance of the menopausal period as the time of increasing CVD risk. It also emphasizes the importance of monitoring the health of women in their middle age, a critical time in which early intervention strategies should be implemented to reduce the risk of CVD.

Familial hypercholesterolemia (FH) is an inherited disorder. The level of low-density lipoprotein cholesterol (LDL-C) in patients with homozygous FH can be twice as high as that in patients with heterozygous FH. The inhibition of ANGPTL3 shows an important therapeutic approach in reducing LDL-C and triglycerides (TG) levels and, thus, is a potentially effective strategy in the treatment of FH. Evinacumab is a monoclonal antibody inhibiting circulating ANGPTL3, available under the trade name Evkeeza^® for the treatment of homozygous FH. It was reported that evinacumab is effective and safe in patients with homozygous and heterozygous FH, as well as resistant hypercholesterolemia and hypertriglyceridemia. This paper summarizes existing knowledge on the role of ANGPTL3, 4, and 8 proteins in lipoprotein metabolism, the findings from clinical trials with evinacumab, a fully human ANGPTL3 mAb, and the place for this new agent in lipid-lowering therapy.

We included 510 consecutive patients from the departments of cardiology and endocrinology, as well as outpatient metabolic and lipid disorder clinics – as a part of the PMMHRI-Lp(a) Registry (NCT06610669), which design and details were presented elsewhere [7]. Medical history was retrospectively extracted from the electronic health records (EHRs). For the purposes of our study, we collected data regarding lipid profile with Lp(a), demographic data, comorbidities, and concomitant medication. We ranged Lp(a) levels based on the following categories: < 30 mg/dl (< 75 nmol/l), 30–50 mg/dl (75–125 nmol/l), > 50–180 mg/dl (> 125–450 nmol/l) and > 180 mg/dl (> 450 nmol/l). Statistical analysis was conducted utilizing Statistica v.13 software (TIBCO Software Inc., Palo Alto, CA, USA). Continuous variables were expressed as mean ± SD or median (25^th–75^th percentile), while categorical variables were presented as proportions. Group comparisons employed Student’s t-test for independent variables and the Mann-Whitney U test or χ² test with Yates’s correction, as applicable. A significance level of p < 0.05 was adopted for all calculations to denote statistical significance. Analysis of the relationship between dependent and independent variables was performed with the use of logistic regression with a backward stepwise method.