I find it strange that there is conflicting research evidence about the effect of fenofibrate on Lp(a)…
You would almost start believing in a big pharma conspiracy 
I found these summary paper very informing;
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Seems pretty clear:
“Fibrates: Bezafibrate has been shown to reduce Lp(a) levels by approximately 13–39% [52]. A similarly modest, but not statistically significant, effect was demonstrated for gemfibrozil [53]. Thus, fibrates do not appear to influence Lp(a) concentrations significantly [54].”
Now if only I could find a source for bezafibrate. It’s unavailable in the USA or India (at least according to one vendor in India).
I have added a low dose Atorvastatin to my Bempedoic Acid and Ezetemibe and my LDL and ApoB are now both 45 down from 68 and 65. HDL is 51.
My hsCRP is 1.59 though and my HBA1C is back up to 5.8 as I stopped Metformin and all supplements except Rapamycin and cholesterol meds for 2 weeks. I’ll bet they’ll be back to normal in 6 months when I check next.
I’m just ecstatic about the LDL and ApoB which are moving in lockstep.
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How low should LDL go?
According to Harvard Medical, the lower the better.
“People who are at high risk for cardiovascular diseases can benefit from driving LDL levels as low as possible to help reduce their risk for heart attacks and strokes,” says cardiologist Dr. Christopher Cannon, editor in chief of the Harvard Heart Letter . “Across many large clinical trials, for LDL, the lower the better.”
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The company and product:
The Company’s Youtube Channel and videos: https://www.youtube.com/@caristodiagnostics
It seems likely it will soon be available in the UK:
Heart & Lung Health (HLH) , a UK-wide network of over 110 expert cardiothoracic radiologists, has partnered with Caristo Diagnostics , a leading cardiac disease diagnostics company, to offer the novel CaRi-Heart® AI technology to predict patients’ risk of developing potentially fatal coronary artery disease.
With the new partnership, HLH will provide the CaRi-Heart AI-based cardiac assessment as a regular part of the organization’s cardiac health check package in multiple sites across the UK.
Interestingly, the company (Caristo) has also partnered with the pharm startup that is repurposing colchicine for inflammation and reduced cardiac risk:
January 25, 2024 — Agepha Pharma, a leading multinational pharmaceutical company with the first FDA-approved anti-inflammatory cardiovascular treatment (LODOCO– colchicine, 0.5 mg tablets), together with Caristo Diagnostics, a leading cardiac disease diagnostics company with the novel CaRi-Heart technology to visualize and quantify coronary inflammation, announced today their collaboration to improve awareness and clinical education about the central role of inflammation in coronary artery disease.
Related: Gout Medication Colchicine Reduce Myocardial Infarction? 2019 N Engl Journal
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by using the AI technology, 45% of those patients were prescribed medication or encouraged to make lifestyle changes to prevent the risk of future heart attacks.
That’s great but what they need to do is a large-scale, long-term follow-up to see which medications and lifestyle changes work the best. Come back periodically for another CT to see if the inflammation / plaque has been reduced.
We’re on the exact same program, I have also added bempadoic acid and ezetemibe to my cardio health protocol. Prior to taking anything my LDL was around 240, with atorvastatin it went down to 140, and now with BA and Ez, its down to 60. No side effects from the medications that I can notice, or see in any blood tests:
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Which bempedoic acid/ez brand are you taking? I took BrilloEZ by SunPharma for several months and shockingly saw virtually no change in my lipids over generic ezetimibe alone. Thinking of trying again by a different manufacturer since that just can’t be right if it was the real thing.
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I am using the same Brillo EZ from Sun Pharma. I bought it from Jagdish.
Same stuff and same source! So strange.
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Different biologies different effects. Sorry it doesn’t work for you. 
Zydus Bemdac
Sun Ezetia
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If I had high LDL for awhile I would nuke the rest from orbit with a PCSK9i and possibly with a statin (nevermind you take statin). I can’t say what you should do though.
Anything above 20 LDL is probably too high.
(Likewise, a stack does not have most of the ITP drugs included, is probably way too few).
(The more drugs someone takes, the healthier they become, the more they slow down the speed of aging and preventing disease).
I use the same brand. Definitely works for me.
What dosage are you using and what were your lipid levels before taking BrilloEZ?
Are you also taking a statin?
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I’m taking PCSK9i (Repatha) and ezetimibe. Switched out the ezetimibe for the combo BA/Ez pill. I can’t tolerate any of the statins at any dose.
That’s the problem with n of 1 studies. There are so many other variables that can confound things. It’s quite possible that I wasn’t disciplined with my diet (since I was on the ultimate non-statin lipid lowering drug therapy combo) and the extra saturated fat counteracted the benefit of the BA. Now that I’m on low dose tirzepatide, dietary discipline is no longer an issue. I’m going to restart the BrilloEZ, since I now feel reassured that it’s not fake.
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I probably would if Repatha was easy to get or inexpensive… but its not. I wouldn’t be able to get a prescription from my PCP, and since it needs to be refrigerated its not an option to import it. I’m paying a few dollars US per week for the statin/Ez/BA combo, so for the results its hard to beat from a price/ performance aspect.
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Lower LDL is the best move against the Chess Master, even better than Rapamycin.
Take A Statin And Chill
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see the discussions about getting the 3x larger Repatha dose that is almost the same price and then your self divide it up into smaller dosages (including the post by dr fraser)
(Similar to what people are doing with the GLP-1 pens).
Given the other cholesterol meds you are taking, you could then also take the repatha a bit less often that people normally do
Doing things those two ways, your cost might only be 1/4 or 1/6th or so and perhaps more reasonable for some people
My experience is that physicians are not adverse to prescribe PCSK9i at all - the thing they might be hesitant to is trying to fight the (often losing) battle for insurance to cover it. So if you say that you will pay cash yourself they see it as a very safe and effective medicine dealing with the largest killer and disabler in the western world (so not like asking them for rapa or something for “longevity”).
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Subdividing Repatha doesn’t apply if taking to reduce LP(a). correct?