Lipoprotein (a) is an independent risk factor for vascular disease. Lipoprotein (a) has many properties in common with low density lipoprotein (LDL) but contains a unique protein, apolipoprotein (a) which is structurally different. Increased plasma lipoprotein levels have been significantly correlated with cardiovascular disease. Elevated levels may interfere with plasminogen action and promote thrombosis.
Lipoprotein (a) concentrations may be affected by disease states (e.g. kidney failure) but are only slightly affected by diet, exercise and other environmental factors. Most commonly prescribed lipid-reducing drugs have little or no effect on Lp(a) concentration.
High Lp(a) predicts risk of early atherosclerosis independently of other cardiac risk factors, including LDL. In patients with advanced cardiovascular disease, Lp(a) indicates a coagulant risk of plaque thrombosis. Uptake via the LDL receptor is not a major pathway of Lp(a) metabolism. The kidney has been identified as playing a role in Lp(a) clearance from plasma.
- Congestive heart failure
- Coronary artery disease
- Cardiovascular disease
- Familial hypercholesterolaemia
- Family history of elevated lipoprotein (a)
- Recurrent cardiovascular disease despite statin treatment