Can Advanced Lipid and Lipoprotein(a) Test Predict a Heart Attack?

Advanced lipid and lipoprotein(a) testing has been shown in some studies to indicate higher risk for heart attacks. This type of advanced testing is more specific than other tests like cholesterol testing and can give doctors more specific information about heart disease risk.

Lipoprotein(a) is one protein found in LDL cholesterol, and levels of this protein may be genetically determined, according to Healthline. Other proteins tested include apolipoprotein B and LDL particle number.

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Doctors may order advanced lipid and lipoprotein(a) testing when other types of testing are inconclusive. According to Harvard Health, those with a history of heart disease, early heart disease, or family history of early heart disease may benefit from advanced lipid and lipoprotein(a) testing.

Docs Opinion cites several studies that show a two to three times higher risk for heart attack and a link between elevated levels of lipoprotein(a) and heart disease. Lp(a) particles are small enough to penetrate the heart’s arterial walls and to transport oxidized phospholipids, which cause inflammation as well. Some experimental data also seems to say that Lp(a) might cause clots to form in arteries that contain a lot of plaque.

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Elevated lipid and Lp(a) levels are difficult to lower because they are largely determined by genetics. Diets rich in saturated fat have lowered Lp(a) levels, though they may not be recommended by doctors for heart disease patients. Monounsaturated fat intake and niacin supplementation also have shown reduction of Lp(a) levels.

Doctors don’t generally focus on lowering these levels until they have addressed the lowering of LDL cholesterol levels. Many heart disease patients have borderline LDL levels, however, and advanced lipid and lipoprotein(a) testing can sometimes shed light on which patients might have an elevated risk of heart attack even when their cholesterol levels aren’t especially high.

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