Lp(a)

At a Glance

Why Get Tested?

As part of a targeted screen for cardiovascular disease (coronary artery disease (CAD) and cerebrovascular disease) risk assessment.

When To Get Tested?

Your doctor may request Lp(a) measurement if you have a family history of premature cardiovascular disease or elevated Lp(a) or if you develop cardiovascular disease at a young age, particularly in the absence of conventional risk factors

Sample Required?

A blood sample taken from a vein in your arm

Test Preparation Needed?

No test preparation is needed.

On average it takes 7 working days for the blood test results to come back from the hospital, depending on the exact tests requested. Some specialist test results may take longer, if samples have to be sent to a reference (specialist) laboratory. The X-ray & scan results may take longer. If you are registered to use the online services of your local practice, you may be able to access your results online. Your GP practice will be able to provide specific details.

If the doctor wants to see you about the result(s), you will be offered an appointment. If you are concerned about your test results, you will need to arrange an appointment with your doctor so that all relevant information including age, ethnicity, health history, signs and symptoms, laboratory and other procedures (radiology, endoscopy, etc.), can be considered.

Lab Tests Online-UK is an educational website designed to provide patients and carers with information on laboratory tests used in medical care. We are not a laboratory and are unable to comment on an individual's health and treatment.

Reference ranges are dependent on many factors, including patient age, sex, sample population, and test method, and numeric test results can have different meanings in different laboratories.

For these reasons, you will not find reference ranges for the majority of tests described on this web site. The lab report containing your test results should include the relevant reference range for your test(s). Please consult your doctor or the laboratory that performed the test(s) to obtain the reference range if you do not have the lab report.

For more information on reference ranges, please read Reference Ranges and What They Mean.

What is being tested?

Lp(a) is a risk factor for heart disease especially when LDL cholesterol is also raised. Lp(a) is a lipoprotein comprising a lipid rich core surrounded by two proteins, apolipoprotein B100 and apolipoprotein (a).

Lp(a) may accelerate atherosclerotic damage (atheroma) by increasing the size of plaque/atheroma in artery walls. It is retained in the artery wall more than LDL cholesterol as it binds to the artery lining through apolipoprotein (a). Lp(a) is also thought to increase risk of heart attacks by interfering with clotting mechanisms and therefore promoting clot development on the inner surface of blood vessels.

This dual action may explain the role of Lp(a) in the promotion of cardiovascular disease (CVD).

Lp(a) concentrations within the blood are genetically determined and will remain fairly constant in an individual over a lifetime. Concentration is not affected by diet, exercise, and other lifestyle modifications used to lower lipids within the blood. Lp(a) concentrations are slightly lower in men than in women and increase slightly in women after the menopause. The concentration of Lp(a) also varies with ethnicity: patients of African American descent can have concentrations up to 4 times higher than Caucasians, but they may not have a higher risk for CAD.

Common Questions

How is it used?

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.

Current advice for the treatment of those known to have a high Lp(a) level is to treat other modifiable risk factors of CAD maximally, particularly LDL cholesterol. Aspirin may be added if there are no contra-indications, in order to reduce the risk of thrombosis. Once levels of Lp(a) have been determined, they do not usually need to be checked again, but it is important to continually monitor the other risk factors. There are several new medications currently in development, which may have an effect on Lp(a) levels.
When is it requested?

Typically, it is requested to estimate an individual’s risk of developing CAD, and it used alongside other risk factors. 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).
What does the test result mean?

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. Therefore, the test result can help doctors give advice on how someone could change their lifestyle habits or go on medications to lower their overall risk of developing CAD.
Is there anything else I should know?

The European Atherosclerosis Society currently recommends patients with an intermediate, moderate or high risk of cardiovascular disease should have their Lp(a) levels measured. This should include those with premature cardiovascular disease, familial hypercholesterolaemia (FH), family history of premature cardiovascular disease, family history of elevated Lp(a) and those with recurrent cardiovascular disease despite optimum medical treatment.