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Another study that analysed the effect of niacin on Lp(a) found that the largest apo(a) isoform sizes (corresponding to lower Lp(a) levels) resulted in a 50% and 4 nmol/l reduction in Lp(a) in absolute terms, while the smallest apo(a) isoform sizes (corresponding to higher Lp(a) levels) showed a reduction in Lp(a) of 16% and 30 nmol/l in absolute terms [141] a similar effect is observed for PCSK9 inhibitors