II. Indications
- Consider in patients at higher risk of ASCVD, to further risk stratify
III. Physiology
- Lipoprotein A is structurally similar to LDL Cholesterol, but with an added group
- Added group is Apoprotein A (apolipoprotein A) linked by disulfide bonds to Apolipoprotein B-100
- Increased Lipoprotein A plasma levels are associated with an increased risk of ASCVD
IV. Interpretation
- Lipoprotein A >50 mg/dl
- Associated with an increased Cardiovascular Risk and stroke
- Lipoprotein A >70 mg/dl
- Associated with high Cardiovascular Risk
V. Efficacy
- Moderate association with ASCVD risk, with generally stable levels after age 5 years, and inexpensive to test
VI. Management
- Lipoprotein A is not lowered by typical Hyperlipidemia Management (e.g. lifestyle, Statins)
- Methods that do lower Lipoprotein A levels (but not FDA approved, and no established protocols)
- PCSK9 Inhibitors
- Lipoprotein Apheresis