Background: Lipoprotein(a) [Lp(a)] is a highly atherogenic lipoprotein and is minimally effected by lifestyle changes. While some drugs can reduce Lp(a), diet has not consistently shown definitive reduction of this biomarker. The effect of consuming a plant‐based diet on serum Lp(a) concentrations have not been previously evaluated.Hypothesis: Consumption of a defined, plant‐based for 4 weeks reduces Lp(a).Methods: Secondary analysis of a previous trial was conducted, in which overweight and obese individuals (n = 31) with low‐density lipoprotein cholesterol concentrations >100 mg/dL consumed a defined, plant‐based diet for 4 weeks. Baseline and 4‐week labs were collected. Data were analyzed using a paired samples t‐test.Results: Significant reductions were observed for serum Lp(a) (−32.0 ± 52.3 nmol/L, P = 0.003), apolipoprotein B (−13.2 ± 18.3 mg/dL, P < 0.0005), low‐density lipoprotein (LDL) particles (−304.8 ± 363.0 nmol/L, P < 0.0005) and small‐dense LDL cholesterol (−10.0 ± 9.2 mg/dL, P < 0.0005). Additionally, serum interleukin‐6 (IL‐6), total white blood cells, lipoprotein‐associated phospholipase A2 (Lp‐PLA2), high‐sensitivity c‐reactive protein (hs‐CRP), and fibrinogen were significantly reduced (P ≤ 0.004).Conclusions: A defined, plant‐based diet has a favorable impact on Lp(a), inflammatory indicators, and other atherogenic lipoproteins and particles. Lp(a) concentration was previously thought to be only minimally altered by dietary interventions. In this protocol however, a defined plant‐based diet was shown to substantially reduce this biomarker. Further investigation is required to elucidate the specific mechanisms that contribute to the reductions in Lp(a) concentrations, which may include alterations in gene expression.

Background and Clinical Significance: Heart failure and kidney diseases often coexist and are difficult to clinically manage. Dysfunction in either organ exacerbates dysfunction in the other, potentially leading to cardiorenal syndrome (CRS). CRS has five different subtypes, with CRS type 5 being the most problematic given that it consists of an acute insult superimposed upon chronic CRS. Additionally, type 5 CRS can be complicated by heart failure-related cardiogenic shock (HF-CS), which is associated with increased hospitalizations and has a high 1-year mortality rate. The standard treatment for patients with HF-CS consists of guideline-directed medical therapy for heart failure with reduced ejection fraction (HFrEF) as tolerated, along with inotropic therapies and surgical mechanical left ventricular (LV) support, guided by invasive hemodynamic monitoring. Case Presentation: This case study reports the presentation of a 57-year-old man who presented with type 5 CRS who rapidly decompensated to stage E HF-CS and was effectively and safely treated with aggressive intravenous hydration, a defined plant-based diet (DPBD), and reduction of guideline-directed prescription medications without invasive hemodynamic monitoring. Conclusions: Hydration, a DPBD, and a reduction in medication burden may be effective in CRS. Pilot studies are warranted to evaluate the efficacy of this intervention in CRS in a larger cohort.