High Lipoprotein (a)

I had a heart attack April 25, 2023. My numbers were all within normal ranges and my new cardiologist after everything was done said no one would consider putting me on meds.

I was at the gym doing a crossfit workout and had chest pain that I though was muscle strain. I stopped and went home. After two days of just feeling off, I went to a walk-in clinic, they sent me to the ER. All of my tests looked normal, but my blood work came back with elevated enzyme showing heart distress, they had drawn multiple times and it was on the decline. They admitted me and scheduled a CAC, I had 100% blocked LAD with home grown bypasses. They installed two stents.

I was later tested for lipid(a) and found to have a score around 170.

My cardiologist says there is nothing to do about that number and to focus on lowering my LDL to below 50, and salts and Saturated fats from my diet.

I don't get as many steps in as you do, probably only 25k - 32k. I'm active but haven always been. I would find a Cardiologist that is aware of the current studies being done about L(a) and get in to see them. But also keep working at being heathly and not over thinking.

wow, that’s amazing. You made it through. That’s great. God was watching over you ! if you don’t mind me asking, how old are you?

I also have high Lp(a) also. My mother had a quadruple bypass. I had normal cholesterol for many years and good HDL. Ran regularly 20-30 miles a week for decades. During X-rays for something else, they found calcifications in the iliac arteries. So they did a CAC and I was in the 98th percentile for coronary atherosclerosis. The biggest thing a doctor would do for you is likely prescribe statins, which you are already on. But there are lifestyle changes you can make also to keep it from progressing (IF you have atherosclerosis, which you may not). So my 2 cents would be to find a preventive cardiologist and discuss it with him/her. I had the Lp(a) test at Mayo, and they gave me a letter to give to my immediate family letting them know it’s a genetic risk factor. This also, I think, is a reason to discuss it with a preventive cardiologist. No reason to panic, but not something to ignore would be my take. Good luck! BTW, I don’t think statins increase Lp(a) and you can’t lower it much. We just got bad genes.

My husband just got the results back from his lab last week, LPA 278, we are concerned.
Last result in November was 209.
( I didn’t had it print out and checked out every single blood number, as the the doctor flew over it with and didn’t say anything about the high number of LDA.
He had a stent put in a year ago (his main artery was blocked 90%) and is on statins, mini aspirin since then…
All other blood result are fine.
We were reading, there is not much you can do about it, than trying to live a healthy lifestyle as good as you can. I was ready too, that it could be a side effect from statins?
We are overwhelmed and would be thankful for every idea.

@rainerhans ,statins made my LP(a) calcium score rise . Not good to take those drugs

Hi @19281928, welcome to Mayo Clinic Connect.

Yes, according to one article on Pub-Med “statin therapy does not lead to clinically important differences in Lp(a) compared to placebo in patients at risk for CVD. Our findings suggest that in these patients, statin therapy will not change Lp(a)-associated CVD risk.”
https://pubmed.ncbi.nlm.nih.gov/34849724/
This article does not say if statins will help with non-LP(a)-associated CVD risk. People with elevated LP(a) may or may not have other risk factors that statins may help with so you will find other member comments across the board on whether they take statins or other cholesterol reducing drugs.

I want to address your comment about statins making your calcium scores rise. I found some information about how statins affect calcium scores.
- Very Well Health: Statins and Your Calcium Score
https://www.verywellhealth.com/statins-and-your-calcium-scores-1746355
Here, the American College of Cardiology report how statins are associated with slowing plaque progression, decreases in events but increase coronary calcium scores:
- The Effect of Statin Therapy on the Progression and Composition of Coronary Atherosclerotic Plaque Identified on Coronary CTA
https://www.acc.org/latest-in-cardiology/articles/2021/11/10/19/50/the-effect-of-statin-therapy-on-the-progression-and-composition-of-coronary-atherosclerotic-plaque
Are you comfortable sharing a bit more about your LP(a) experience? What other cardiovascular risk factors do you have?

My suggestion for anyone who has high LP (a) and asymptomatic, to go through Heart CT Angio, which is non-intrusive test and does 2 things:
- Tells calcium deposit score (ideally 0)
- Looks deposits in heart arteries and pics of vales
Gives you a sense whats going on inside. Fortunately, mine came as 22 (not ideal but not bad) and condition of arteries looks ok with CT with some minor plaques. Me and my cardiologist now focus on prevention vs any kind of treatment.

I believe that the statin raised your LP(a) as it definitely raised mine. I will never touch a statin drug again.