Just found out Lpa is extremely high — other risks OK

Your immediate task is to stop worrying, but you're going about that process sensibly by educating yourself so that you can let the worry go. It's not going to help you anyway.

Diagnostics will tell the story. You will, or should be, invited to try an angiogram, or an MRI, or a stress test with CT scan and contrast radio-opaque dye. Maybe all of them, as I was, because they kept finding nothing wrong. They finally sent me to a sleep lab overnight and I was found to have severe sleep apnea. All this because I suddenly developed atrial fibrillation one morning during a run. My numbers weren't good either, but my vessels and heart all look good. When I had the angiography, and this is before any statins and after decades of all them not-great numbers, the surgeon leaned over to me as he was withdrawing the arm-inserted catheter and said, 'Minor deposits, you're good.' Later, I asked my PCP for a Doppler ultrasound of my carotid arteries because my dad, at 88 had just been found to have the same extent of blockage in his left carotid as your brother's cardiac artery. His right carotid was 199% blocked, and the vascular surgeon said she wouldn't dream of trying to bypass that one. My dad is a healthy and disciplined eater, grew most of his own vegetables, mowed his own lawns, was not big on sweets, all his life. But imagine the meaning of those blockages in vessels meant to feed his engineer's brain.

I'm suggesting that the numbers you have are only a snapshot. They represent blood levels, not what is deposited in your blood vessels. You need other tests to determine how much, if any, deposition you need to worry about.

I recently read that stains could increase LPa - not sure of the source.

Just a quick comment on your total cholesterol and HDL.

While not a medical professional, your total cholesterol seems high - 100 is usually a spot we shoot for if we have heart disease - or are concerned about heart disease.

Again, not a medical professional, but there is a limit to how high HDL should be ... it is not clearly delineated, but my sense is 95 is very high - some articles mention 80 as the upper limit before looking for other causative factors.

Yes, I read it too. It increases LPa 10% to 20%

I'll add a bit more from my experience and research: If one is at risk for CVD, then the LDL numbers start to matter a lot. Having LDL under 70 is the goal and under 55 or so if there is coronary vascular disease (CVD). Also, as noted here, HDL is a U-shaped thing: good at certain levels then becomes a risk factor if high (I think over 90 or 95).

Also, for the original poster: when you see the cardio specialist, ask about Lipoprotein A and B testing, as they are additional risk factors to be considered, and those hide in your LDL results unless specifically tested.

I am sorry you have this. I just found out about it myself, very similar profile to you. I just joined this group. I am a little freaked myself, but have an endocrinologist I trust. Unfortunately, she is moving and I will have a new one, but hoping this new one with be as good as her. Statins made me so achy and I thought I needed PT. I stopped them a week ago and I am much better. I am trying Praluent. I am trying to educate myself. That's all we can do. Keep taking care of yourself. It has to help (that's what I tell myself). I tried to get on the Eli Lilly trial for their LP (a) medication, but they are looking for people who also have other ailments like HBP, diabetes, .... A new drug is coming out soon to target LP (a). Maybe by 2027. I am looking at that as a light at the end of the tunnel and hoping it will be affordable.

I have been watching Peter Attia on YouTube and got his book OUTLIVE from my library. I think he makes a lot of sense.

Best wishes.

Totally recommend “outlives” by Peter Attia! I just finished reading it a month ago and I started an exercise routine that has changed my life at 68. LP.a means that you inherited a familial mutation for heart disease folks!!!! it does not mean that you express it!!!! Every test is an “indicator“. It means nothing by itself. None of the tests do! They’re all indicators alone. What means everything is the condition of your heart and arteries as in photographs of them. The photographs and a qualified cardiologistwill tell you if you have heart disease.
I have it and it runs in my family and people were having their first stroke, heart attack attacks, and death in their late 50s. Thank goodness I have always eaten right, exercised as best I could and taken care of my health. I have had ALL the tests. I have all the scores of the lipid panels. I have seen a cardiologist specialist. I can’t take statins nor do I want to because I don’t think they prevent plaque from laying down in your arteries, but I get the injections of LEVQIO twice a year. What matters is the snapshot of your heart and arteries. Then armed with that, you can look at the numbers from the tests and your expert cardiologist can determine a path for you.
Strangely, you can have one really bad score and then have another really great score on something else and until you’ve had a gazillion million scores of tests the unique situation for you individually can’t be pieced together. So relax and make sure you have a good cardiologist to rely on.
What you have to differentiate is what is in your control going forward and what is not in your control. Taking care of your health in eating low-fat diets and exercising even if it’s walking and breathing every day is going to do everything within your means to keep your heart and arteries in their best shape. Taking whatever medications the doctors think is best for you and seeing a cardiologist once a year as your age will determine your own unique path fortunately, for me, I came from great grandparents all of them that lived well into their mid and late 90s — on both sides. Each generation after lost a decade on their longevity. Heart disease doesn’t need to shorten your life if you pay attention to guarding your health. The lean diet my great grandparents had because of their hard life and the amount of activity that was required. (they had no cars!) the fresh fruits and vegetables, and non-processed diet they ate, kept them all living extraordinary, long lives in good health, even though they obviously had the disease because it was found in my genetic mutations. Hang in there, adopt good habits, learn as much as you can and don’t worry!