Lipoprotein (a) [Lp(a)]

 

Lipoprotein(a) [Lp(a)] is a cholesterol-carrying particle similar to LDL, but with an extra protein attached.Levels are almost entirely genetic and stay stable throughout life, with little effect from lifestyle or standard lipid treatments.

High Lp(a) increases the risk of early cardiac disease, stroke, and aortic valve disease.

Measuring Lp(a) helps identify people with inherited high levels so their overall cardiovascular risk can be managed more aggressively.

 

Summary

The lipid clinic have provided a useful summary of Lpa(a) assessment and management at the end of the adult lipid management document

The key points from this are below:

• There is currently no treatment for raised Lp(a)
• Measuring Lp(a) is useful in appropriate patient groups to stratify cardiovascular disease (CVD) risk and guide intensity of lipid management
• It should ONLY be measured ONCE in high risk patient groups:
  • Personal or family history of:
    • premature CVD <60 years
    • Recurrent/ multiple CVD events
    • FH history of significantly raised Lp(a)  - details in link above
    • Genetic dyslipidemias e.g. Familial Hypercholesterolemia
    • Calcific aortic valve stenosis

Interpretation, lipid management and referral

Interpretation of Lp(a), lipid management intensity, and referral criteria are summarised in the table below:

References

Royal Cornwall Hospitals NHS Trust. Adult Lipid Management (Mx) Pathways Clinical Guideline (V1.0). Published 11 March 2026. Available at: http://doclibrary-rcht.cornwall.nhs.uk/DocumentsLibrary/RoyalCornwallHospitalsTrust/Clinical/Pathology/AdultLipidManagementMxPathwaysClinicalGuideline.pdf

 

Page Review Information

Review date:           27 March 2026
Next review date:    27 March 2028
Clinical editors:        Dr Jack Munro Berry – RMS GP
Contributors:           Dr Rachel Cooper – Consultant Clinical Biochemist