Cardiologists, too, are on the fence about who should get screened, and when. McGarrah would like to see a one-time Lp(a) screening when a person gets their first routine cholesterol panel. “Whether it is [age] 18 or 25 or later, it would be good to incorporate an Lp(a) test — usually covered by insurance — to better contextualize their risk of developing cardiovascular disease,” he said. But Paruchuri thinks screening for Lp(a) is better used with patients with borderline risk. “As a patient, having an elevated Lp(a) level but no clear treatment plan could cause significant anxiety and/or increase the use of other cardiac testing unnecessarily,” she said.