Lp-PLA2 (lipoprotein-associated phospholipase A2) is an enzyme that hydrolyzes oxidized phospholipids in LDL cholesterol, producing pro-inflammatory compounds that contribute to atherosclerosis. This test measures Lp-PLA2 activity to assess cardiovascular disease risk in patients without prior cardiovascular events. Elevated Lp-PLA2 activity indicates increased inflammation within atherosclerotic plaques and is associated with higher risk of coronary heart disease, stroke, and cardiovascular events. The test is particularly valuable for risk stratification in patients with intermediate cardiovascular risk, as it provides information beyond traditional lipid measurements. Lp-PLA2 activity can help guide decisions about preventive treatments and lifestyle modifications. This marker is independent of other cardiovascular risk factors and may identify patients who would benefit from more aggressive risk factor management.