Lp(a)

Lp(a) may be requested with other lipid tests in patients who have developed cardiovascular disease at a young age or who have a family history of premature heart disease. Its measurement will tell the doctor whether the concentration of Lp(a) is contributing to the patient’s risk of cardiovascular disease. Since the concentration of Lp(a) is largely genetically determined, lifestyle changes or treatment with statins or fibrates will usually be ineffective in lowering the concentration in the blood, although treatment with niacin or nicotinic acid may achieve a 20% reduction.  If an elevated concentration of Lp(a) is found,  your doctor will treat modifiable risk factors more aggressively to minimise cardiovascular risk.

Lp(a) may be requested, with other lipid tests, when you have a family history of premature coronary artery disease or of raised Lp(a), or you have developed symptoms of  cardiovascular disease at a young age which are not explained by conventional risk factors (e.g. high total cholesterol or LDL-cholesterol).

Lp(a) concentrations within the blood are genetically determined and remain relatively constant over an individual’s lifetime. They are not affected by lifestyle changes or by most drugs.

High Lp(a) concentrations increase a person’s risk for developing coronary artery disease and cerebral vascular disease, especially in patients with hypercholesterolaemia Elevated concentrations of Lp(a) are thought to work independently, to add to any underlying heart or vascular disease processes. Conditions associated with elevatedconcentrations of Lp(a) include:

• Chronic renal failure
• Oestrogen depletion
• Familial hypercholesterolemia
• Myocardial infarction (heart attack)
• Premature coronary artery disease
• Severe hypothyroidism
• Stenosis of cerebral arteries
• Stroke
• Uncontrolled diabetes

Low concentrations of Lp(a) do not appear to cause problems. They may be seen with:

• Alcoholism
• Chronic liver disease
• Malnutrition

Although some cardiologists and other doctors occasionally request Lp(a), it is not a routinely used test. It is not routinely used and is currently not recommended for widespread testing. 

 In general, lipids should not be measured during a fever or major infection, within 4 weeks of an acute myocardial infarction (heart attack), a stroke, or major surgery, after excessive alcohol intake, when you have severely uncontrolled diabetes, when you are pregnant, or during rapid weight loss.