Lipoprotein(a) is a variant of LDL particle and has in addition to apolipoprotein B, apolipoprotein(a).
Lipoprotein(a) is a strong independent risk factor for premature coronary artery disease (CAD). Atherogenicity of Lipoprotein(a) is 10-fold higher than that of LDL. It is highly thrombogenic and antifibrinolytic, by virtue of its homology to plasminogen. While HDL is considered the “good cholesterol”; LDL the “bad cholesterol” and triglyceride the “ugly cholesterol”, Lipoprotein(a) can be considered as the “Deadly Cholesterol”.

Lipoprotein(a) levels are genetically determined with environmental factors having only a negligible impact. Childhood levels of Lp(a) are a better predictor and marker for future CAD in young adult life than any other lipoproteins. 15-20 mg/dL is now considered the threshold.