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The results of the above studies suggest that genetic testing and phenotyping should be ordered in patients with elevated Lp(a) levels, which could serve as an additional tool to assess CVD risk, to personalise and select the best available therapy (statins, niacin, PCSK9 inhibitors) [142, 143]

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This suggests that early post-operative metabolic adaptation may induce modest changes in insulin resistance, requiring long follow-up to detect meaningful improvement

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