Lipoprotein (a) Blood Test
Lipoprotein (a) has been called a powerful predictor of premature coronary artery disease. Excess Lp(a) concentrations are associated with an increased risk of cardiac death in patients with acute coronary syndromes and with restenosis after angioplasty (PTCA) and coronary bypass procedures. In general, concentrations >30 mg/dL of Lp(a) in serum are associated with a two- to sixfold increase in risk, depending on the presence of other risk factors.
Measurement of lipoprotein (a) is now recommended in several patient subgroups for whom excess lipoprotein (a) may have important clinical consequences:
- patients with premature atherosclerosis
- patients with a strong family history of premature coronary heart disease (CHD),
- patients with elevated LDL-C and greater than or equal to two risk factors
- patients who have had coronary angioplasty in whom lipoprotein (a) excess may increase the risk of restenosis
- patients who have undergone coronary bypass graft surgery in whom Lp(a) excess may be associated with graft stenosis.
The Lp(a) levels in different ethnic populations can vary widely. Africans, or people of African descent, generally have Lp(a) levels higher than Caucasians and Asians, while Native Americans generally have levels lower than Caucasians. This variability of Lp(a) levels by ethnic population requires careful interpretation of results based on a knowledge of the patient and other cardiac risk factors which may be present.
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