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Lipoprotein(a), commonly abbreviated as Lp(a), is a specific type of lipoprotein particle found in the blood. It consists of a low-density lipoprotein (LDL) core with an additional protein called apolipoprotein(a) attached to it. Unlike other cholesterol particles, Lp(a) levels are primarily determined by genetics rather than diet or lifestyle factors. Elevated levels of Lp(a) are associated with an increased risk of cardiovascular diseases, including heart attack and stroke, as well as calcific aortic valve stenosis. Testing for Lp(a) helps identify individuals who may have an inherited predisposition to cardiovascular disease that would not be detected by standard cholesterol tests.

The Lp(a) test measures the concentration of lipoprotein(a) in the blood, typically reported in milligrams per deciliter (mg/dL) or nanomoles per liter (nmol/L). This test is usually performed on a blood sample drawn from a vein in the arm. Unlike cholesterol tests, fasting is generally not required before an Lp(a) test, since food intake does not significantly affect Lp(a) levels. The test is particularly useful for people with a family history of early heart disease, those who have had cardiovascular events despite normal cholesterol levels, or individuals with recurrent cardiovascular problems despite appropriate treatment.

Lp(a) levels tend to remain relatively stable throughout a person's life, as they are largely genetically determined. Normal or desirable Lp(a) levels are generally considered to be less than 30 mg/dL or less than 75 nmol/L, though specific reference ranges may vary between laboratories. Levels above these thresholds are associated with progressively higher cardiovascular risk. Since Lp(a) is inherited, elevated levels often run in families, and testing may be recommended for family members of individuals with high Lp(a) levels.

Managing elevated Lp(a) levels can be challenging because traditional cholesterol-lowering interventions like diet modification and exercise have minimal impact on Lp(a) concentrations. Some medications, including certain types of cholesterol-lowering drugs, may help reduce Lp(a) levels, though their effectiveness varies. For individuals with high Lp(a), healthcare providers typically focus on aggressively managing other modifiable cardiovascular risk factors such as LDL cholesterol, blood pressure, smoking, and diabetes. Regular monitoring and a comprehensive cardiovascular risk reduction strategy are essential for people with elevated Lp(a) levels.