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Question:
What does a high LPpla2 mean and does it warrant cardiac CT and meds at this time?
Hello,
I am a 49 yr old female. I just recently had bloodwork done and was surprised to find that my results showed very high marker Lp lpa2 of 322. My other results were borderline range: total cholesterol 207, HDL 58, LDL 123 and triglycerides 141. My blood pressure ranges in the 120/80 range when monitored at different times. I do have a family hx of heart problems on my fathers side (mostly all of the men in the family). My family dr. wants me to have a cardiac CT and to begin Vytorin. I would rather try lifestyle changes first as I have been been exercising due to heavy work load/stress.
submitted by Renee from Austin, Texas on 10/3/2015
Answer:
by Texas Heart Institute cardiologist, Scott R. Sherron, MD 
Lpa is a marker that places you in a higher risk category for development of heart disease compared to a population without elevation of this marker. It certainly does not mean that you definitively have or will develop heart disease. However, since you are at an increased risk, it makes sense to be somewhat more aggressive with modification of those risk factors that can be modified (Lpa, like family hx, cannot directly be altered). Taking measures to optimize your LDL (definitely below 100) whether that be by lifestyle modification or meds or both would be recommended. A CT scan can help you and your doctor decide how aggressive to be in these efforts as well as direct the frequency of screening exams like treadmill testing. For example, an elevated calcium score on cardiac CT might prompt a goal LDL of as low as 70 which would almost certainly require medication to achieve.
I hope this is helpful.
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Updated October 2015
