This episode reviews the clinical application of lipoprotein(a) and apolipoprotein B in cardiovascular risk assessment based on AHA ACC guidance. It emphasizes the genetic determination and stability of lipoprotein(a), supporting its role as a one time measurement for risk stratification, along with the importance of cascade screening in identifying inherited risk. The discussion outlines how lipoprotein(a) levels correlate with graded increases in cardiovascular risk and contribute to atherosclerosis, thrombosis, and calcific aortic valve disease. It also highlights apolipoprotein B as a direct measure of atherogenic particle burden, providing additional risk refinement beyond traditional cholesterol metrics, particularly in patients with metabolic disease or discordant lipid profiles. Key takeaways include appropriate use of advanced lipid markers, integration with PREVENT risk estimation, recommended monitoring strategies during lipid lowering therapy, and evidence based thresholds for treatment intensification to reduce long term cardiovascular risk..