Lipoprotein(a) (Lp(a))
Lp(a) is a genetically determined LDL-like particle. Elevated Lp(a) is an independent risk factor for early coronary disease, valve calcification and stroke — and is largely unaffected by statins or diet.
What it measures
Lp(a) is an LDL-like particle plus apolipoprotein(a), with a level set almost entirely by genetics — your value is roughly stable for life. The 2019 ESC dyslipidaemia guideline recommends measuring Lp(a) at least once in adulthood because elevated values triple the risk of premature myocardial infarction and accelerate aortic-valve calcification. About 20% of people carry levels in the high-risk band, often unaware.
What a high value can mean
- ≥125 nmol/L (≈≥50 mg/dL) — high cardiovascular risk; aggressive LDL lowering and risk-factor control advised.
- ≥175 nmol/L — very high risk; consider lipoprotein apheresis or emerging PCSK9 / pelacarsen trials.
- Family history of early heart attack or stroke sharply amplifies the meaning of any elevation.
- Aortic stenosis at younger age — Lp(a) drives valve calcification.
What a low value can mean
- Generally favourable. Low Lp(a) is not pathological and needs no intervention.
When to discuss with a doctor
If your Lp(a) is in the high-risk band, the standard playbook is to lower LDL aggressively (statin + ezetimibe; consider PCSK9 inhibitor when warranted), tightly control blood pressure, stop smoking and discuss family screening with your physician. Mediora.AI surfaces Lp(a) alongside your LDL trajectory; treatment changes belong with a clinician.