Lipoprotein(a) — Lp(a)
Last reviewed 25 August 2026 · Evidence-graded review — see Methodology
An LDL-like particle carrying an additional apolipoprotein(a) component. Lp(a) is roughly 70–90% genetically determined and essentially fixed for life after early adulthood — diet and exercise barely move it, which is why it only needs measuring once. It promotes atherosclerosis much as LDL does, inhibits fibrinolysis, and independently drives calcific aortic valve disease.
Kamstrup PR, Tybjærg-Hansen A, Steffensen R, Nordestgaard BG. “Genetically Elevated Lipoprotein(a) and Increased Risk of Myocardial Infarction.” JAMA 2009;301(22):2331–2339 tied genetically elevated Lp(a) to a graded increase in MI risk, supporting a causal role. The gap is therapeutic: as of 2026 no Lp(a)-lowering drug has completed a cardiovascular outcomes trial proving that lowering Lp(a) itself reduces events, with pelacarsen and olpasiran trials still running. Testing today informs risk stratification and more aggressive management of other modifiable risk factors — it does not yet lead to a targeted prescription.
Kamstrup PR, et al. JAMA. 2009. PubMed: PMID 19509380
Singapore guidance
Not one of the named screening tests
Not among the tests Singapore’s national screening committee names for lipid screening.
Source: Screening Test Review Committee report 2026, Volume 1 (Academy of Medicine Singapore and Ministry of Health, February 2026). The full national list · How this is used.
What you would actually pay
- Healthier SG
- Not subsidised
- MediSave
- Not among the screenings named for outpatient claims
Source: Healthier SG Screening (HealthHub) and MediSave outpatient care (Ministry of Health). Absence from either list is not a statement that the test is discouraged — only that no subsidy or claim applies. Gross prices compared.
What it costs when it is wrong
- Basis
- No published harm criterion found
- Severity
- Not documented
No published harm criterion found for this test.
An empty finding, not a clean bill of health: this means nothing documented was found for this test. It is not a claim that the test is safe.
Screening harm is not only a laboratory question: the committee’s own criteria advise against a test when “the screening test, or follow-up tests arising from a positive screen, are associated with significant medical risks”. Sources on overdiagnosis → · How this is graded.
Singapore pricing. We have a full price breakdown for this test, using checked 2026 figures from named providers — read the price guide →
FAQ
Is the Lipoprotein(a) — Lp(a) worth doing in Singapore?
For adults without symptoms, Lipoprotein(a) — Lp(a) sits at the moderate grade on our evidence scale. It typically costs S$50–100 in Singapore. The usual schedule: once in a lifetime (European Atherosclerosis Society guidance) — it doesn't meaningfully change. It is most appropriate for ideally every adult once; at minimum, anyone with premature family history of heart disease or unexplained high risk despite normal LDL-C.
Weighing this against something else? Compare it with two other tests → · Price it inside a panel →