Lipids - Lipoprotein (a)

Lp(a) measurement could be of value in those with a family history of premature CVD (greater 60 years), especially when a causative mutation for familial hypercholesterolemia (FH) hasn’t been identified. In patients with heterozygous FH (HeFH), Lp(a) levels are higher compared to their non-affected siblings. Lp(a) has been identified as a strong risk factor of coronary heart disease (CHD) in patients with HeFH, independent of age, sex, smoking status, and LDL-C levels.

Understanding a FH patients Lp(a) levels can aid the physician in identifying the patient’s risk of a cardiovascular event and in the evaluation of treatment methods. However, Lp(a) is not a predictor of CHD in HeFH patients on currently available cholesterol-lowering treatment but may be when lower LDL-C levels are achieved. On this basis, it is recommended that Lp(a) levels are measured in all genetic dyslipidaemias