Lp-PLA2 (lipoprotein-associated phospholipase A2)
An enzyme carried mostly on LDL cholesterol that is produced by inflammatory cells inside the artery wall. Unlike general inflammation markers, it points specifically to inflammation within atherosclerotic plaque, and is used to refine cardiovascular risk beyond standard cholesterol.
What it measures
Lipoprotein-associated phospholipase A2 (Lp-PLA2) is an enzyme made by inflammatory cells (macrophages) within atherosclerotic plaque and transported in the blood largely bound to LDL cholesterol. It acts on oxidised fats inside the artery wall, generating substances that promote inflammation and can make plaque more unstable and prone to rupture — the event that triggers many heart attacks and strokes. What makes Lp-PLA2 distinctive is that it is relatively specific to the artery wall itself, so it is far less influenced than general markers like CRP by unrelated infection or inflammation elsewhere in the body. It is used as an add-on test to refine cardiovascular risk assessment in people at intermediate risk, helping decide how aggressively to treat, rather than to diagnose a heart attack or replace standard lipids. It is measured either as an activity or a mass (concentration) assay. It is one of a small group of 'vascular inflammation' markers, alongside hs-CRP and myeloperoxidase, that add nuance to a risk picture built mainly on cholesterol, blood pressure and lifestyle.
What a high value can mean
- Increased vascular inflammation and cardiovascular risk — associated with a higher risk of heart attack and stroke, and with more rupture-prone plaque.
- A reason to treat risk factors more intensively — often prompting firmer cholesterol and lifestyle management.
- Used with LDL and hs-CRP — refines, rather than replaces, the standard risk picture.
High Lp-PLA2 (lipoprotein-associated phospholipase A2): full guide
What a low value can mean
- Lower vascular inflammation — a reassuring result, though it does not remove the need to manage other risk factors.
- Effect of treatment — statins and lifestyle change can lower it.
Low Lp-PLA2 (lipoprotein-associated phospholipase A2): full guide
When to discuss with a doctor
Lp-PLA2 is a specialised, add-on cardiovascular risk marker rather than a routine or diagnostic test. Its value is in people at intermediate risk, where a raised level can tip the balance toward more intensive management of cholesterol, blood pressure and lifestyle — it does not diagnose or rule out a heart attack, and chest pain still needs urgent assessment in its own right. It is always interpreted alongside the standard picture: LDL cholesterol, blood pressure, smoking, diabetes and family history. A high Lp-PLA2 is a prompt to strengthen prevention, not a cause for alarm. Mediora.AI shows Lp-PLA2 alongside LDL, hs-CRP and the rest of your lipid and inflammation markers so the vascular-risk pattern is read together; how to act on it belongs with your doctor.