Lp(a)Lipoprotein(a)

Lipoprotein(a), or Lp(a), is an LDL-like particle with an extra protein attached. Its level is roughly 80–90% genetically determined and stays fairly stable through life, largely unaffected by diet or lifestyle.

It matters because a high Lp(a) is an independent, causal risk factor for heart attack and stroke — and because it is inherited, one measurement can flag lifelong elevated risk that standard cholesterol testing misses.

In practice, guidelines increasingly recommend measuring Lp(a) at least once in adulthood; levels at or above about 125 nmol/L (≈50 mg/dL) are considered high risk.

Sources

• Koschinsky ML, et al. A focused update to the 2019 NLA scientific statement on use of lipoprotein(a) in clinical practice. J Clin Lipidol 2024