Lipoprotein (a): a risk factor for atherosclerosis: importance in clinical practice.

Lipoprotein (a) [Lp(a)] is a LDL-like particle linked to an apolipoprotein (a) wich has high sequence homology with plasminogen that gives Lp(a) thrombogenic properties in addition to atherogenic capacity. Many epidemiological studies have shown that a high plasma level of Lp(a) is a risk factor for coronary, cerebral and peripheral atherosclerosis. Out of thirteen prospective studies, ten have confirmed this result. The negative results from the three remaining studies were probably due to either inadequate storage of the samples or preventive drug treatment given to the patients during the studies. This review of the literature clearly demonstrates the relationship between Lp(a) and atherosclerosis and the need to measure Lp(a) in order to better evaluate the risk of atherosclerotic vascular disease especially in patients with a hyper LDLemia, an early cardio-or cerebrovascular disease or a family history of atherosclerosis.