Lipoprotein(a) [Lp(a)] is a unique lipoprotein particle that combines LDL cholesterol with apolipoprotein(a), creating an independent risk factor for cardiovascular disease. This test measures Lp(a) levels to assess cardiovascular risk beyond traditional lipid measurements. Elevated Lp(a) levels are associated with a 2-6 fold increased risk of premature coronary artery disease, stroke, and peripheral vascular disease. Lp(a) promotes atherosclerosis through multiple mechanisms including promoting inflammation, inhibiting fibrinolysis, and contributing to plaque formation. The test is particularly valuable for evaluating patients with premature cardiovascular disease, those with a strong family history of heart disease, and individuals with elevated LDL cholesterol who have additional risk factors. Lp(a) levels are largely genetically determined and remain relatively stable throughout life, making them a reliable long-term cardiovascular risk marker.