Heart attack risk and Lipoprotein(a)

Heart attack risk and Lipoprotein(a)

Ever Heard of lipoprotein(a)?

Try asking your primary care doctor if they’ve ever checked your lipoprotein(a) level. If it’s high, do they know what to do about it? Lipoprotein(a) (Lp[a]), pronounced literally as ‘little-a,’ is something that rarely gets checked in primary care. It’s not something that gets a lot of attention, in the United States anyway, but it needs to become a routine screening. It only ever needs to be done once – as you either have elevated levels of it, or you don’t. 

What Exactly is It?

Lipoprotein(a) is a type of apoB particle (read about apoB here) – having the same density as an LDL-particle as measured in the lab – that has an extra protein, called a Kringle, attached to it. Lipoprotein(a) can lead to an increase in atherosclerosis (plaque deposited in the artery wall), aortic stenosis (narrowing of a heart valve opening), and a potential for faster development of blood clots (suspected to perhaps be an evolutionary advantage). 

Heart attack risk and Lipoprotein

Apolipoprotein B particles, the right which has the additional Lp(a) kringle attached.

Illustration credit: Thomas Dayspring, MD, FACP, FNLA.

Why You Should Care

To make it simple, there’s an increased risk of having a heart attack or other cardiovascular issues if your Lp(a) level is elevated. There is some good scientific data that has established a strong link between Lp(a) and a number of different adverse cardiovascular problems, maily heart attack (4x increased risk); aortic stenosis (3x increased risk); and coronary atherosclerosis (narrowing of the arteries in the heart) (5x increased risk). 

What Can You Do About It?

There are a few approaches that are routinely used to reduce the risk from Lp(a):

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