Lipoprotein(a) Test
Also known as: Lp(a), Lipoprotein Little A
What is Lipoprotein(a)?
Lipoprotein(a), or Lp(a), is a type of LDL particle with an additional protein called apolipoprotein(a) attached. High levels are an independent genetic risk factor for cardiovascular disease.[American Heart Association]
What This Test Measures
This test measures the concentration of Lp(a) particles in your blood. Unlike other cholesterol markers, Lp(a) levels are largely determined by genetics and do not change much with diet or lifestyle.[Cleveland Clinic]
Why It's Important
Elevated Lp(a) is an independent risk factor for heart disease, stroke, and aortic valve disease that is not captured by standard lipid panels.[American Heart Association]
High Lp(a) can explain why some people with normal cholesterol still develop heart disease.[Cleveland Clinic]
Who Should Get This Test?
Lp(a) testing helps identify genetic cardiovascular risk not captured by standard lipid panels.
Risk Factors
- Personal history of premature cardiovascular disease
- Family history of early heart attack or stroke
- Familial hypercholesterolemia
- Heart attack or stroke despite normal cholesterol
- Recurrent cardiovascular events on statin therapy
- Aortic stenosis at younger age
- Family member with elevated Lp(a)
- Ethnic groups with higher prevalence (South Asian, African descent)
Screening Schedule
Once in a lifetime is usually sufficient since Lp(a) is genetically determined and remains stable. Repeat testing is rarely needed unless confirming initial result.
What Happens During the Test
A blood sample is drawn from a vein. Lp(a) is measured using immunoassay methods. Fasting is not required, though it may be done with fasting lipid panel.
Duration
5-10 minutes for blood draw; results typically available within 1-3 days
Discomfort Level
Minimal discomfort from needle insertion
Risks & Side Effects
Standard blood draw with minimal risks.
- •Brief pain at needle site
- •Small bruise may develop
- •Rare: lightheadedness
- •Very rare: infection at puncture site
Normal Range
Desirable: Less than 30 mg/dL (or less than 75 nmol/L). Elevated: 30-50 mg/dL. High: Greater than 50 mg/dL.
Note: Lp(a) levels are primarily determined by genetics and remain stable throughout life.
Source: American Heart AssociationUnit Conversion
Convert between mg/dL and nmol/L
| mg/dL | nmol/L |
|---|---|
| 20 | 50 |
| 30 | 75 |
| 50 | 125 |
| 75 | 188 |
| 100 | 250 |
High Values
High Lp(a) increases the risk of heart attack, stroke, and aortic stenosis. Since it is genetic, lifestyle changes have limited effect, but controlling other risk factors becomes more important.[Cleveland Clinic]
Low Values
Low Lp(a) is favorable and indicates lower genetic cardiovascular risk from this marker.[American Heart Association]
Test Limitations & Accuracy
Lp(a) testing has several considerations:
- ⚠Different assays may give different results due to Lp(a) size variability
- ⚠Results may be reported in mg/dL or nmol/L which are not directly convertible
- ⚠No FDA-approved therapy specifically targets Lp(a) yet
- ⚠Lifestyle changes have minimal effect on levels
- ⚠Some conditions (kidney disease, hypothyroidism) can raise Lp(a)
- ⚠Menopause and hormone therapy can affect Lp(a) levels
- ⚠Insurance coverage varies; may not be covered for routine screening
Alternative & Complementary Tests
Lp(a) is complementary to other cardiovascular risk markers:
Standard lipid measurement; Lp(a) adds genetic risk information
Measures total atherogenic particle number
Imaging test to detect existing arterial plaque
Inflammatory marker for cardiovascular risk
To identify familial hypercholesterolemia mutations
Frequently Asked Questions
Can I lower my Lp(a)?
Lp(a) levels are largely genetic and do not respond significantly to diet or exercise. PCSK9 inhibitors can modestly reduce Lp(a). New therapies targeting Lp(a) directly are in development.
Source: American Heart AssociationWho should get Lp(a) tested?
Testing is recommended if you have a personal or family history of early heart disease, familial hypercholesterolemia, or if you have had a heart attack or stroke despite normal cholesterol levels.
Source: Cleveland ClinicIs Lp(a) hereditary?
Yes, Lp(a) levels are approximately 90% determined by genetics. If you have high Lp(a), your family members should also be tested.
Source: American Heart AssociationReferences
Related Condition Guides
Medical Disclaimer
This information is for educational purposes only and is not intended as medical advice. Always consult with a qualified healthcare provider for interpretation of test results and medical decisions.
Track your Lipoprotein(a) results over time
Start Tracking Free