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Lipoprotein(a)

Drugs and Chemicals · NLM MeSH · updated 2026-10-31 · version 1

Citations verified against PubMedNot yet clinician-reviewed10 referencesApproximately 5 min read

A lipoprotein that resembles the low-density lipoproteins but with an extra protein moiety, apoprotein (A) also known as apolipoprotein (A), linked to apolipoprotein b-100 on the LDL by one or two disulfide bonds.

Table of Contents

1. Definition2. Research landscape3. Reading the evidence4. Open-access studies5. Key reviews6. References7. About this article

Definition and research guide

This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.

Content available: 4 complete abstracts (1,018 words), 10 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.

Definition

A lipoprotein that resembles the low-density lipoproteins but with an extra protein moiety, apoprotein (A) also known as apolipoprotein (A), linked to apolipoprotein b-100 on the LDL by one or two disulfide bonds. High plasma level of lipoprotein (a) is associated with increased risk of atherosclerotic cardiovascular disease.

Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.

Also known as: Lipoprotein a; Lipoprotein Lp(a); Lipoprotein (a); Lipoprotein (a-).

Where it fits in the MeSH classification

Broader topics
Lipoproteins
Narrower topics
Apoprotein(a)

Related concepts

  • Low-Density Lipoproteins
  • Apoprotein
  • Apolipoproteins
  • Apolipoprotein B-100

Research landscape

PubMed indexes 6,827 records tagged with the MeSH heading “Lipoprotein(a)” (counts retrieved 2026-10-31). 1,706 of them (25.0%) were published from 2020 onward, and the busiest period so far is through 1999 with 2,505 records.

Reviews account for 1,132 records (16.6%) and meta-analyses for 132. Randomized controlled trials number 399 (5.8%) as a share of all records on the topic.

PubMed records by publication periodthrough 1999: 2,505 records; 2000-2009: 1,389 records; 2010-2019: 1,227 records; 2020 onward: 1,706 records2,505through 19991,3892000-20091,2272010-20191,7062020 onward
Records in PubMed indexed with this heading, by publication period. Real counts from NCBI E-utilities; the final period covers only part of the current year. Volume reflects how much has been published, not how strong the evidence is.
Show the data
PeriodRecords
through 19992,505
2000-20091,389
2010-20191,227
2020 onward1,706
Share of records by publication typeReviews: 16.6 percent; Meta-analyses: 1.9 percent; Randomized controlled trials: 5.8 percentReviews16.6% (1,132)Meta-analyses1.9% (132)Randomized controlled trials5.8% (399)
Share of all PubMed records on this heading that carry each publication type. Types overlap with other records, so the shares do not sum to 100%.
Publication-type chart data
Publication types among 6,827 PubMed records
TypeRecordsShare
Reviews1,13216.6%
Meta-analyses1321.9%
Randomized controlled trials3995.8%

Method: PubMed query "Lipoprotein(a)"[MeSH Terms] with publication-type and date filters, retrieved 2026-10-31.

Reading the evidence in drugs and chemicals

Studies of a chemical or drug can answer very different questions: what it is and how it behaves in cells and animals, how the body handles it, and whether it changes outcomes in people. Laboratory and animal findings often do not carry over to patients, and observational studies of exposures are confounded by who uses a substance and why. Nothing on this page is a recommendation to use, avoid, start or stop any substance or medicine; talk to a qualified clinician or pharmacist about your own situation. Check the dose, the species, the comparison group and whether a patient-relevant outcome was measured.

Evidence from open-access studies

These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.

Study comparison — selected abstracts, not a systematic review
Study / authorsYearSource label / designEurope PMC citationsLicence / source
Lipoprotein(a) Is Markedly More Atherogenic Than LDL: An Apolipoprotein B-Based Genetic Analysis
Björnson E, Adiels M, Taskinen MR, Burgess S, Chapman MJ, Packard CJ, et al.
2024Research article
Design not recorded in structured metadata
182cc by
PMID 38233012 · DOI · PMC7616706
Non-genetic influences on lipoprotein(a) concentrations
Enkhmaa B, Berglund L
2022Review article
Design not recorded in structured metadata
125cc by
PMID 35606076 · DOI · PMC9549811
Independence of Lipoprotein(a) and Low-Density Lipoprotein Cholesterol-Mediated Cardiovascular Risk: A Participant-Level Meta-Analysis
Bhatia HS, Wandel S, Willeit P, Lesogor A, Bailey K, Ridker PM, et al.
2025Meta-analysis
Design not recorded in structured metadata
98cc by
PMID 39492722 · DOI · PMC11771346
Lipoprotein(a) and incident venous thromboembolism in pre- and postmenopausal women, and in men
Ezzat D, Lopez DM, Claggett BL, Li L, Mohammadnia N, Schuermans A, et al.
2026Research article
Design not recorded in structured metadata
6cc by
PMID 41903523 · DOI · PMC13266305

Lipoprotein(a) Is Markedly More Atherogenic Than LDL: An Apolipoprotein B-Based Genetic Analysis [1]

Research article Björnson E, Adiels M, Taskinen MR, Burgess S, Chapman MJ, Packard CJ, et al. · · 2024 · cited 182 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
BackgroundLipoprotein(a) (Lp(a)) is recognized as a causal factor for coronary heart disease (CHD) but its atherogenicity relative to that of low-density lipoprotein (LDL) on a per-particle basis is indeterminate.
Closing excerpt
Therefore, Lp(a) represents a key target for drug-based intervention in a significant proportion of the at-risk population.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (244 words)

BackgroundLipoprotein(a) (Lp(a)) is recognized as a causal factor for coronary heart disease (CHD) but its atherogenicity relative to that of low-density lipoprotein (LDL) on a per-particle basis is indeterminate.ObjectivesThe authors addressed this issue in a genetic analysis based on the fact that Lp(a) and LDL both contain 1 apolipoprotein B (apoB) per particle.MethodsGenome-wide association studies using the UK Biobank population identified 2 clusters of single nucleotide polymorphisms: one comprising 107 variants linked to Lp(a) mass concentration, the other with 143 variants linked to LDL concentration. In these Lp(a) and LDL clusters, the relationship of genetically predicted variation in apoB with CHD risk was assessed.ResultsThe Mendelian randomization-derived OR for CHD for a 50 nmol/L higher Lp(a)-apoB was 1.28 (95% CI: 1.24-1.33) compared with 1.04 (95% CI: 1.03-1.05) for the same increment in LDL-apoB. Likewise, use of polygenic scores to rank subjects according to difference in Lp(a)-apoB vs difference in LDL-apoB revealed a greater HR for CHD per 50 nmol/L apoB for the Lp(a) cluster (1.47; 95% CI: 1.36-1.58) compared with the LDL cluster (1.04; 95% CI: 1.02-1.05). From these data, we estimate that the atherogenicity of Lp(a) is approximately 6-fold (point estimate of 6.6; 95% CI: 5.1-8.8) greater than that of LDL on a per-particle basis.ConclusionsWe conclude that the atherogenicity of Lp(a) (CHD risk quotient per unit increase in particle number) is substantially greater than that of LDL. Therefore, Lp(a) represents a key target for drug-based intervention in a significant proportion of the at-risk population.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 38233012 · DOI · PMC7616706

Non-genetic influences on lipoprotein(a) concentrations [2]

Review article Enkhmaa B, Berglund L · · 2022 · cited 125 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
An elevated level of lipoprotein(a) [Lp(a)] is a genetically regulated, independent, causal risk factor for cardiovascular disease.
Closing excerpt
Overall, current evidence supports a role for diet, hormones and related conditions, and liver and kidney diseases in modifying Lp(a) levels.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (241 words)

An elevated level of lipoprotein(a) [Lp(a)] is a genetically regulated, independent, causal risk factor for cardiovascular disease. However, the extensive variability in Lp(a) levels between individuals and population groups cannot be fully explained by genetic factors, emphasizing a potential role for non-genetic factors. In this review, we provide an overview of current evidence on non-genetic factors influencing Lp(a) levels with a particular focus on diet, physical activity, hormones and certain pathological conditions. Findings from randomized controlled clinical trials show that diets lower in saturated fats modestly influence Lp(a) levels and often in the opposing direction to LDL cholesterol. Results from studies on physical activity/exercise have been inconsistent, ranging from no to minimal or moderate change in Lp(a) levels, potentially modulated by age and the type, intensity, and duration of exercise modality. Hormone replacement therapy (HRT) in postmenopausal women lowers Lp(a) levels with oral being more effective than transdermal estradiol; the type of HRT, dose of estrogen and addition of progestogen do not modify the Lp(a)-lowering effect of HRT. Kidney diseases result in marked elevations in Lp(a) levels, albeit dependent on disease stages, dialysis modalities and apolipoprotein(a) phenotypes. In contrast, Lp(a) levels are reduced in liver diseases in parallel with the disease progression, although population studies have yielded conflicting results on the associations between Lp(a) levels and non-alcoholic fatty liver disease. Overall, current evidence supports a role for diet, hormones and related conditions, and liver and kidney diseases in modifying Lp(a) levels.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 35606076 · DOI · PMC9549811

Independence of Lipoprotein(a) and Low-Density Lipoprotein Cholesterol-Mediated Cardiovascular Risk: A Participant-Level Meta-Analysis [3]

Meta-analysis Bhatia HS, Wandel S, Willeit P, Lesogor A, Bailey K, Ridker PM, et al. · · 2025 · cited 98 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
BackgroundLow-density lipoprotein cholesterol (LDL-C) and lipoprotein(a) (Lp[a]) levels are independently associated with atherosclerotic cardiovascular disease (ASCVD).
Closing excerpt
ConclusionsThese findings demonstrate the independent and additive nature of Lp(a) and LDL-C levels for ASCVD risk, and that LDL-C lowering does not fully offset Lp(a)-mediated risk.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (268 words)

BackgroundLow-density lipoprotein cholesterol (LDL-C) and lipoprotein(a) (Lp[a]) levels are independently associated with atherosclerotic cardiovascular disease (ASCVD). However, the relationship between Lp(a) level, LDL-C level, and ASCVD risk at different thresholds is not well defined.MethodsA participant-level meta-analysis of 27 658 participants enrolled in 6 placebo-controlled statin trials was performed to assess the association of LDL-C and Lp(a) levels with risk of fatal or nonfatal coronary heart disease events, stroke, or any coronary or carotid revascularization (ASCVD). The multivariable-adjusted association between baseline Lp(a) level and ASCVD risk was modeled continuously using generalized additive models, and the association between baseline LDL-C level and ASCVD risk by baseline Lp(a) level by Cox proportional hazards models with random effects. The joint association between Lp(a) level and statin-achieved LDL-C level with ASCVD risk was evaluated using Cox proportional hazards models.ResultsCompared with an Lp(a) level of 5 mg/dL, increasing levels of Lp(a) were log-linearly associated with ASCVD risk in statin- and placebo-treated patients. Among statin-treated individuals, those with Lp(a) level >50 mg/dL (≈125 nmol/L) had increased risk across all quartiles of achieved LDL-C level and absolute change in LDL-C level. Even among those with the lowest quartile of achieved LDL-C level (3.1-77.0 mg/dL), those with Lp(a) level >50 mg/dL had greater ASCVD risk (hazard ratio, 1.38 [95% CI, 1.06-1.79]) than those with Lp(a) level ≤50 mg/dL. The greatest risk was observed with both Lp(a) level >50 mg/dL and LDL-C level in the fourth quartile (hazard ratio, 1.90 [95% CI, 1.46-2.48]).ConclusionsThese findings demonstrate the independent and additive nature of Lp(a) and LDL-C levels for ASCVD risk, and that LDL-C lowering does not fully offset Lp(a)-mediated risk.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 39492722 · DOI · PMC11771346

Lipoprotein(a) and incident venous thromboembolism in pre- and postmenopausal women, and in men [4]

Research article Ezzat D, Lopez DM, Claggett BL, Li L, Mohammadnia N, Schuermans A, et al. · · 2026 · cited 6 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
Background and aimsElevated lipoprotein(a) [Lp(a)] levels are an established risk factor for atherosclerotic cardiovascular disease, but the association between Lp(a) and venous thromboembolism (VTE) remains unclear.
Closing excerpt
ConclusionsElevated Lp(a) was associated with VTE in premenopausal women and in postmenopausal MHT users, suggesting that hormonal context may influence Lp(a)-associated thrombotic risk.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (265 words)

Background and aimsElevated lipoprotein(a) [Lp(a)] levels are an established risk factor for atherosclerotic cardiovascular disease, but the association between Lp(a) and venous thromboembolism (VTE) remains unclear. Sex and hormonal status may modify the relationship between Lp(a) and VTE.MethodsThe present study included participants from the UK Biobank with available baseline Lp(a) data. Individuals with a history of VTE or cancer, as well as those using anticoagulants, were excluded. Multivariable-adjusted Cox models were used to assess the association between Lp(a) levels ≥125 nmol/L and incident VTE in premenopausal women, postmenopausal women, and men. Subgroup analyses stratified premenopausal women by oral contraceptive (OCP) use and postmenopausal women by menopausal hormone therapy (MHT) use.ResultsAmong 55 302 premenopausal women, 129 045 postmenopausal women, and 189 013 men, the proportions with Lp(a) ≥ 125 nmol/L were 14.0%, 19.0%, and 15.0%, respectively. Over a median (interquartile range) follow-up of 13.6 (12.9-14.4) years, 8186 VTE events occurred (cumulative incidence 2.2%). Lp(a) ≥ 125 nmol/L was associated with incident VTE in premenopausal women [adjusted hazard ratio (aHR) 1.32; 95% confidence interval (CI) 1.04-1.66; P = .02] but not in postmenopausal women (aHR 1.03; 95% CI 0.94-1.13; P = .47; Pinteraction = .03) or men (aHR 1.00; 95% CI 0.92-1.08; P = .94). OCP use did not modify the Lp(a)-VTE association among premenopausal women (Pinteraction = .61). However, among postmenopausal MHT users, Lp(a) ≥ 125 nmol/L was associated with higher VTE risk (aHR 1.48; 95% CI 1.03-2.12; P = .03; Pinteraction = .04).ConclusionsElevated Lp(a) was associated with VTE in premenopausal women and in postmenopausal MHT users, suggesting that hormonal context may influence Lp(a)-associated thrombotic risk.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 41903523 · DOI · PMC13266305

Key reviews and meta-analyses

The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.

  • Research article Lipoprotein(a) concentration and the risk of coronary heart disease, stroke, and nonvascular mortality [5]
    Emerging Risk Factors Collaboration, Erqou S, Kaptoge S, Perry PL, Di Angelantonio E, Thompson A, et al. · JAMA · 2009 · cited 1,354 times (Europe PMC)
  • Research article Lipoprotein(a) as a cardiovascular risk factor: current status [6]
    Nordestgaard BG, Chapman MJ, Ray K, Borén J, Andreotti F, Watts GF, et al. · Eur Heart J · 2010 · cited 1,324 times (Europe PMC)
  • Research article A Test in Context: Lipoprotein(a): Diagnosis, Prognosis, Controversies, and Emerging Therapies [7]
    Tsimikas S · J Am Coll Cardiol · 2017 · cited 857 times (Europe PMC)
  • Research article Lipoprotein(a): A Genetically Determined, Causal, and Prevalent Risk Factor for Atherosclerotic Cardiovascular Disease: A Scientific Statement From the American Heart Association [8]
    Reyes-Soffer G, Ginsberg HN, Berglund L, Duell PB, Heffron SP, Kamstrup PR, et al. · Arterioscler Thromb Vasc Biol · 2022 · cited 612 times (Europe PMC)
  • Research article Lipoprotein(a) and coronary heart disease. Meta-analysis of prospective studies [9]
    Danesh J, Collins R, Peto R · Circulation · 2000 · cited 562 times (Europe PMC)
  • Research article Baseline and on-statin treatment lipoprotein(a) levels for prediction of cardiovascular events: individual patient-data meta-analysis of statin outcome trials [10]
    Willeit P, Ridker PM, Nestel PJ, Simes J, Tonkin AM, Pedersen TR, et al. · Lancet · 2018 · cited 439 times (Europe PMC)

References

  1. Björnson E, Adiels M, Taskinen MR, Burgess S, Chapman MJ, Packard CJ, et al.. Lipoprotein(a) Is Markedly More Atherogenic Than LDL: An Apolipoprotein B-Based Genetic Analysis. . 2024. PMID 38233012 · DOI · PMC7616706
  2. Enkhmaa B, Berglund L. Non-genetic influences on lipoprotein(a) concentrations. . 2022. PMID 35606076 · DOI · PMC9549811
  3. Bhatia HS, Wandel S, Willeit P, Lesogor A, Bailey K, Ridker PM, et al.. Independence of Lipoprotein(a) and Low-Density Lipoprotein Cholesterol-Mediated Cardiovascular Risk: A Participant-Level Meta-Analysis. . 2025. PMID 39492722 · DOI · PMC11771346
  4. Ezzat D, Lopez DM, Claggett BL, Li L, Mohammadnia N, Schuermans A, et al.. Lipoprotein(a) and incident venous thromboembolism in pre- and postmenopausal women, and in men. . 2026. PMID 41903523 · DOI · PMC13266305
  5. Emerging Risk Factors Collaboration, Erqou S, Kaptoge S, Perry PL, Di Angelantonio E, Thompson A, et al.. Lipoprotein(a) concentration and the risk of coronary heart disease, stroke, and nonvascular mortality. JAMA. 2009. PMID 19622820 · DOI · PMC3272390
  6. Nordestgaard BG, Chapman MJ, Ray K, Borén J, Andreotti F, Watts GF, et al.. Lipoprotein(a) as a cardiovascular risk factor: current status. Eur Heart J. 2010. PMID 20965889 · DOI · PMC3295201
  7. Tsimikas S. A Test in Context: Lipoprotein(a): Diagnosis, Prognosis, Controversies, and Emerging Therapies. J Am Coll Cardiol. 2017. PMID 28183512 · DOI
  8. Reyes-Soffer G, Ginsberg HN, Berglund L, Duell PB, Heffron SP, Kamstrup PR, et al.. Lipoprotein(a): A Genetically Determined, Causal, and Prevalent Risk Factor for Atherosclerotic Cardiovascular Disease: A Scientific Statement From the American Heart Association. Arterioscler Thromb Vasc Biol. 2022. PMID 34647487 · DOI · PMC9989949
  9. Danesh J, Collins R, Peto R. Lipoprotein(a) and coronary heart disease. Meta-analysis of prospective studies. Circulation. 2000. PMID 10973834 · DOI
  10. Willeit P, Ridker PM, Nestel PJ, Simes J, Tonkin AM, Pedersen TR, et al.. Baseline and on-statin treatment lipoprotein(a) levels for prediction of cardiovascular events: individual patient-data meta-analysis of statin outcome trials. Lancet. 2018. PMID 30293769 · DOI

About this article

Sources
NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
Verification
Every reference was resolved against PubMed on 2026-10-31; title, year and DOI matched.
Review state
automated source verified; no human expert review has been recorded yet.
Version
1, last updated 2026-10-31.

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All 546 articles in Drugs and Chemicals →

At a glance

6,827
PubMed records on this heading
25%
published since 2020
1,132
review articles
399
randomized trials
10
verified references below

Counts come from PubMed on 2026-10-31; they show how much has been written, not how strong the evidence is.

Related topics See all →

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