What is Lipoprotein A / LP(a) test?
Lipoprotein A (LP(a)) test is a blood test that evaluates LP(a) levels in the blood. LP(a) is a type of lipoprotein that carries cholesterol in the bloodstream, usually consisting of low-density lipoprotein (LDL). So, high levels of LP(a) in the blood indicate a higher risk of cardiovascular diseases (CVDs).
As LDL is considered to be bad cholesterol, LP(a) is considered as a risk factor for CVD. It is important to note that LP(a) test is not a routine test and is used as a part of cardiac risk assessment; wherein, elevated levels indicate increased risk. It is usually evaluated along with lipid panel to assess the risk of heart disease.

  1. Why is a Lipoprotein A / LP(a) test performed?
  2. How do you prepare for a Lipoprotein A / LP(a) test?
  3. How is a Lipoprotein A / LP(a) test performed?
  4. Lipoprotein A / LP(a) test results and normal range

LP(a) is usually evaluated along with lipid panel, especially in individuals who have a family history of heart diseases or elevated levels of LDL at a younger age.
Apart from this, other reasons to evaluate LP(a) include the following:

  • An existing vascular or heart disease and or mildly elevated lipid levels (high LDL and low HDL)
  • High lipid levels, despite a healthy diet
  • In case a person on anti-dyslipidaemic therapy has higher levels of lipids
  • A history of stroke or heart attack, despite normal or near-normal lipid levels 

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No special preparations are required for the LP(a) test. But it is usually evaluated along with lipid panel, which might require about 9 to 12 hours of fasting.

LP(a) test is a simple procedure that takes less than 5 minutes. An experienced laboratory specialist will insert a small needle into a vein in your arm to withdraw a small quantity of blood into a sterile vial or a test tube. You may feel a momentary pricking pain when the needle goes into the vein.
Also, there is a slight risk of light-headedness or bruising at the site of injection. However, most times, these symptoms disappear immediately and rarely, an infection might occur at the site of withdrawal of blood.

LP(a) values are expressed in mg/dL.

Normal results:
LP(a) values less than 30 mg/dL indicate normal results.
Levels of LP(a) are lower in men compared to women and it tends to be on a higher side in menopausal women.

Abnormal results:
Lipoprotein levels over 30 mg/dL are considered as abnormal or high.
High levels of LP(a) levels indicate the following:

  • Increased risk of CVDs
  • Increased risk of stroke
  • Increased risk of dyslipidaemia

LP(a) promotes deposition of LDLs in the inner walls of blood vessels (especially veins) and results in the formation of plaque. These plaques can narrow down or block the blood vessels resulting in atherosclerosis (hardening of the walls of arteries) and can cause a heart attack or stroke.
In case of menopausal women, if elevated LP(a) levels are associated with low levels of oestrogen, then it increases the risk for heart diseases.
LP(a) levels can be altered or may turn falsely elevated in case of fever, infection, pregnancy or recent considerable weight loss.

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LP(a) test is not solitarily used or performed routinely. It is usually recommended for people who have a previous history of heart disease or have a very strong family history of cardiovascular diseases or when a person has elevated levels of lipids (high levels of LDL or low levels of HDL). It is usually performed along with lipid panel, stress test or echocardiography.

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. The above information is provided from a purely educational point of view and is in no way a substitute for medical advice by a qualified doctor.

References

  1. National Heart, Lung, and Blood Institute [Internet]: U.S. Department of Health and Human Services; Blood Tests
  2. Maciej Banach. Lipoprotein (a)—We Know So Much Yet Still Have Much to Learn J Am Heart Assoc. 2016 Apr; 5(4) PMID: 27108250
  3. UW Health. [Internet] UW Hospital and Clinics, University of Wisconsin Hospital and Clinics, Madison, Wisconsin. My Child’s Lipoprotein (a) Level
  4. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; Lipoprotein(a) Cholesterol
  5. UF Health. [Internet] University of Florida Health, Florida, U.S. Lipoprotein-a
  6. Rami S. Najjar, Carolyn E. Moore, Baxter D. Montgomery. Consumption of a defined, plant‐based diet reduces lipoprotein(a), inflammation, and other atherogenic lipoproteins and particles within 4 weeks Clinical Cardiology: International Journal for Cardiovascular Diseases, Volume 41, Issue 8, Pages 1062-1068
  7. Karam M.Kostner, Gert M.Kostner. Lipoprotein(a):A Historical Appraisal The Journal of Lipid Research, 2017, Jan;58(1):1-14
  8. National Heart, Lung, and Blood Institute [Internet]: U.S. Department of Health and Human Services; Future Research Directions on Lipoprotein(a) and Cardiovascular Disease
  9. Szternel L et al. Non-fasting lipid profile determination in presumably healthy children: Impact on the assessment of lipid abnormalities. PLoS One. 2018 Jun 21;13(6) PMID: 29927973
  10. Cleveland Clinic. [Internet]. Cleveland, Ohio. Lipoprotein(a) -Treating the Untreatable
  11. Paul K. Whelton et al. Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines Hypertension, June 2018 Vol 71, Issue 6
  12. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; Lipoprotein(a) Cholesterol
  13. Lipoprotein (a) Foundation. [Internet] California, U.S. What is inherited high Lipoprotein(a)
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