Markers · Cardiovascular

Lp(a) came back high, and it's mostly set by your genes. Lp(a), read against the rest of you.

What Lp(a) measures, what it does in the body, why it's tested, and the two ranges it's read against. Everything said about the marker here comes from Merlin's own biomarker catalogue.

What Lp(a) is

Lipoprotein(a) is a genetically determined lipoprotein particle composed of an LDL-like core with apolipoprotein B-100 covalently bound to apolipoprotein(a), and elevated levels are a strong, independent risk factor for cardiovascular disease, atherosclerosis, and aortic stenosis. Unlike most lipid markers, Lp(a) levels are approximately 80-90% determined by genetics (LPA gene variants) and are largely unresponsive to standard lifestyle interventions. Elevated Lp(a) promotes both atherogenesis and thrombosis by impairing fibrinolysis, making it a critical marker for residual cardiovascular risk not captured by standard lipid panels.

What it does in the body

Lp(a) transports cholesterol and phospholipids in the bloodstream and may play a role in wound healing and tissue repair due to its structural similarity to plasminogen. However, its pathological roles include promoting atherosclerotic plaque formation by delivering oxidized phospholipids to arterial walls, inhibiting plasminogen activators to impair fibrinolysis, and contributing to platelet aggregation and thrombosis, collectively accelerating cardiovascular disease progression.

Why it's tested

Lp(a) testing is used to assess residual cardiovascular risk beyond standard lipid panels, identify individuals with familial hypercholesterolemia or premature atherosclerotic cardiovascular disease (ASCVD), stratify risk for major adverse cardiovascular events (MACE), aortic valve stenosis, and stroke, and guide more aggressive preventive treatment decisions. It is recommended at least once in an adult's lifetime as a screening tool, particularly in those with a family history of premature CVD or recurrent cardiovascular events despite statin therapy.

The two ranges

The reference range reflects population statistics. The target reflects physiology.

Lab reference range: < 50 mg/dL (< 125 nmol/L); levels ≥ 50 mg/dL (≥ 125 nmol/L) are considered high risk
Functional target: < 30 mg/dL (< 75 nmol/L)

Those are different numbers, and you deserve to know which one you're looking at. Merlin reads your result against both.

Where this lives

A Field Guide to Atherosclerotic Risk

The field guide that covers Lp(a) in depth, whole and public.

Read the guide

In a real read

Lp(a) at 17 is in the real Cardiovascular read on this site, where a low Lp(a) is credited against an ApoB of 117 rather than passed over. The read shows what it looks like when a low number is weighed too.

A real Cardiovascular surface from a real anonymized panel: the score, the narrative, the layers underneath. Yours will be built the same way, on your own numbers.

See the full read

Educational context for your conversations with your licensed healthcare provider, not a diagnosis or a treatment plan. Merlin reads results; it doesn't diagnose.