Lipoprotein(a) [Lp(a)]

The Lipoprotein(a) [Lp(a)] test measures the level of Lp(a) in the blood. Lp(a) is a type of lipoprotein similar to LDL (low-density lipoprotein) but includes an additional protein called apolipoprotein(a). Elevated Lp(a) levels are associated with an increased risk of cardiovascular disease, including heart attack and stroke, regardless of other cholesterol levels.

1. What Is Lipoprotein(a)?

• Lp(a) is a lipoprotein particle composed of LDL-like cholesterol and a unique protein component, apolipoprotein(a).

• Its structure makes it more likely to contribute to plaque buildup in arteries (atherosclerosis).

• Lp(a) levels are largely inherited and not significantly affected by diet or lifestyle.

2. Why Is the Lp(a) Test Performed?

This test is used to:

• Assess cardiovascular risk in individuals with a personal or family history of heart disease or stroke.

• Evaluate unexplained high cholesterol or early-onset heart disease.

• Identify individuals with genetic lipid disorders such as familial hypercholesterolemia.

• Support cardiovascular risk assessment in patients with borderline lipid levels.

3. Lp(a) Reference Range

• Desirable: < 30 mg/dL (or < 75 nmol/L)

• Borderline high: 30–50 mg/dL

• High: > 50 mg/dL (or > 125 nmol/L)

• Risk increases as Lp(a) levels rise, particularly above 50 mg/dL or 125 nmol/L.

4. Interpreting Lp(a) Results

🔹 Elevated Lp(a):

• Suggests increased risk for atherosclerotic cardiovascular disease (ASCVD), including coronary artery disease and stroke.

• May warrant more aggressive management of other cardiovascular risk factors (e.g., LDL, blood pressure, smoking).

🔹 Normal Lp(a):

• Indicates standard genetic risk for cardiovascular disease.

• Still requires monitoring of other cholesterol and lifestyle factors.

5. What Can Affect Lp(a) Levels?

• Genetics (major determinant)

• Lp(a) levels are not significantly altered by diet, exercise, or most cholesterol medications.

• Certain therapies, like PCSK9 inhibitors or niacin, may lower Lp(a) in some cases.

6. How Is the Test Performed?

• A blood sample is collected from a vein.

• Fasting is usually not required, but follow your provider's instructions.

7. When to See a Doctor

🚨 Consult your healthcare provider if you:

• Have a personal or family history of early heart attack or stroke.

• Have high cholesterol that does not respond to lifestyle changes.

• Need a more comprehensive cardiovascular risk assessment.

🔹 Key Takeaways

✅ Lipoprotein(a) is a genetically influenced marker of cardiovascular risk.

✅ Elevated levels increase the likelihood of heart attack and stroke, even with normal cholesterol.

✅ Early detection helps guide prevention strategies and personalized treatment.