[The smoking gun of cardiovascular diseases? The great interest in Lp(a)-lipoprotein].

A highly significant association (p < 0.001) was found in 1971-1972 between pre-beta-1 lipoprotein and coronary heart disease. Later, pre-beta-1 lipoprotein was in fasting serum samples found to be equivalent to Lp(a) lipoprotein. Continuing structural and clinical studies further documented the high atherogenicity of Lp(a) and revealed probable pathogenetic mechanisms. Interest in Lp(a) has increased tremendously during the last few years due to the recent overwhelming support for an independent association between Lp(a) and atherosclerotic disorders and the revelations of its fascinating structure. The structure of Lp(a), its association with clinical disorders and probable pathogenetic mechanisms are exemplified and discussed in relation to type of developed atheromas, their susceptibility to disruption and the importance of inherited high Lp(a) levels for the thrombotic complications.